Prospective, randomised clinical trial of four different presurgical hand antiseptic techniques in equine surgery
Bibliographic record
Abstract
BACKGROUND: Currently, the World Health Organization recommends the use of alcohol-based hand rubs (ABR) for surgical hand preparation in human surgery. When disinfecting soaps are used, a rubbing technique causes less skin irritation than brush scrubbing. Based on a recent survey, most equine surgeons still use disinfecting soap. The efficacy of scrubbing vs. rubbing and the use of sole ABR compared with chlorhexidine (CHx)- based products has not been evaluated in the equine surgical setting. OBJECTIVES: To compare four surgical hand antisepsis techniques in equine surgery for reduction of aerobic bacterial counts from pre- to post-preparation (immediate efficacy) and at the end of surgery (sustained efficacy). STUDY DESIGN: Randomised, prospective clinical trial. METHODS: A 4% CHx-based product applied with either a scrub or rub technique, one sole ABR (ET; 80% ethanol) and one CHx/alcohol-combination (CHx/ET; 1% CHx and 61% ethanol) product both applied with a rub technique were evaluated. Samples were collected by glove juice technique and cultured on 3M™ Petrifilm plates and counted using a 3M™ Petrifilm plate reader. RESULTS: colony forming unit (CFU) reduction was 2.4 for CHx-scrub, 2.8 for CHx-rub, 3.1 for CHx/ET and 2.1 for ET. CHx/ET resulted in significantly lower bacterial counts than CHx-scrub (P<0.005) and ET (P<0.001) while CHx-rub resulted in significantly lower counts than ET (P<0.001). At the end of surgery bacterial counts were the lowest for CHx-rub, significantly lower than CHx/ET (P<0.001) and ET (P<0.001). There was no difference between CHx-rub and -scrub techniques (P = 0.7). MAIN LIMITATIONS: Bacterial counts were used as the outcome measure rather than prevalence of surgical site infection, and the effect of hand preparation on skin health was not assessed. CONCLUSIONS: CFU counts more effectively than CHx products. When using CHx soaps in the equine setting, hand-rub is as effective as a hand-scrub-technique.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".