Hand HygieneNCT06420934
Surgical Handwashing: Drying With One or Two Surgical Towels
A study testing Drying procedure after surgical handwashing in people with Hand Hygiene and Surgical Wound Infection, run by Instituto de Ortopedia Infantil Roosevelt at 1 site in Colombia.
Trial summary
This study aims to determine whether the use of two sterile towels for drying after surgical handwashing results in fewer contamination events compared to the use of only one towel among healthcare personnel. Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Hand Hygiene, Surgical Wound Infection, Healthcare Associated Infection
- What is being tested?
- Drying procedure after surgical handwashing
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 72 participants
- Where
- 1 siteColombia
- Study dates
- 26 Apr 2024to 30 Jun 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Workers and students who have a current affiliation with the institutions where the study will be executed.
- Workers and students whose practice or work involves performing surgical handwashing at least once a week for invasive procedures.
Who cannot join
- Workers and students who do not wish to participate in the study.
- Workers and students whose work activities do not allow them time to participate in the study.
- Workers and students who are allergic to the fluorescent cream
- Workers and students whose nails exceed a length of 0.5 cm from the fingertip edge.
- Workers and students whose nails are painted with polish.
- Workers and students who refuse to remove jewelry and accessories from wrists and hands.
- Workers and students with recent wounds on hands or forearms, including tattoos done in the last month.
- Workers and students who do not adhere to the handwashing and drying technique taught prior to the study's implementation.
Trial locations and contacts
1 site in 1 country.
Colombia1 site, 1 recruiting
- Recruiting
Instituto Ortopedia Infantil Roosevelt
Bogotá, Bogota D.C., 110231
Maria Fernanda Garcia, MD, MSc, +573208541343, f.garcia@ioir.org.co
Manuela Quiroga-Carrillo, MD, +576013534000 ext. 263, mquiroga@ioir.org.co
About this study
Official title: Comparison of the Breach of the Aseptic Barrier After Surgical Handwashing: Drying With One or Two Surgical Towels
This study aims to determine whether the use of two sterile towels for drying after surgical handwashing results in fewer contamination events compared to the use of only one towel among healthcare personnel. This randomized, multicenter, superiority-controlled trial will enroll up to 72 healthcare workers and surgical residents from three hospitals in Bogotá, Colombia. A fluorescent product will simulate bacteria, and contamination will be assessed by evaluating the presence of fluorescent cream after hand drying technique with either two or one surgical sterile towel. Data will be collected through REDCap and deidentified. Differences in the proportion of contamination between the two groups will be assessed using an exact Fischer test, and confounding variables will be included in the analysis through logistic multivariate regression, with a significance level set a priori at 0.05. Results will be submitted for publication in a peer-reviewed journal.
Read the detailed description
Approval was obtained from the ethics committee of three healthcare institutions. A process of informed consent will be conducted with all participants, and confidentiality and data protection will be guaranteed. A research assistant, unaware of the operational hypotheses and study objectives, will execute the experiment and record the results. There will be no blinding of the intervention for the participants or the assistant. At each institution, randomization will be conducted a priori to determine the operating room where participants should be recruited. Likewise, the intervention to be administered will be randomized. All these data will be stored in opaque envelopes that will be opened at the time of recruitment. A total of 72 participants will be recruited, with 36 exposed to drying with one towel and 36 to drying with two towels. Recruitment will cease upon completion of the respective participants stipulated for each intervention.
The primary outcome of interest will be the presence or absence of contamination. To evaluate this outcome, the gold standard would be the collection of cultures and the analysis of the presence or absence of bacterial contamination. However, due to the costs and methodological difficulties of taking cultures, an indirect method, previously validated as a surrogate, will be employed instead. 2 mL of fluorescent cream (Glo Germ ™) will be applied with a brush proximal to the normally washed area during surgical scrubbing (3 cm above the elbow). Participants will be shown a video on how to dry with one or two surgical towels and will be given one minute to do so. Subsequently, the presence or absence of fluorescent cream on the upper extremities will be evaluated using a UV light lamp. If fluorescence is evidenced in the washed area where it was not applied, it will be considered that there was contamination during the hand drying process.
No interim analyses will be executed. Data will be de-identified for the analysis. Descriptive statistics will be conducted using R studio, and proportions of contamination when drying with one or two towels will be compared. A simple logistic regression will be performed to assess the relationship between the intervention and the proportion of contamination events, and a multivariate logistic regression will be conducted to assess the effect of confounding variables on the outcome. The results will be reported collectively for publication in a peer-reviewed journal.
- Being tested
- Drying procedure after surgical handwashing
- Keywords
- Surgical Scrubbing, Handwashing, Disinfection, Healthcare Associated Infection, Hand Hygiene
- Medical subject headings
- Surgical Wound Infection, Cross Infection
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Drying procedure after surgical handwashingOther
Participants will dry their hands with one surgical towel
| Study group | Role | What they receive |
|---|---|---|
| One surgical towel | Active comparator | Participants will be asked to remove all accessories from the forearm, wrist, fingers and to roll up any clothing until at least 5 cm above the humeral condyles are exposed. They will be instructed to perform conventional surgical scrubbing and to dry their hands with a conventional paper towel. The research assistant will open the opaque envelope, which will indicate that the participant needs to dry their hands with one surgical towel. Receives: Other: Drying procedure after surgical handwashing |
| Two surgical towel | Experimental | Participants will be asked to remove all accessories from the forearm, wrist, fingers and to roll up any clothing until at least 5 cm above the humeral condyles are exposed. They will be instructed to perform conventional surgical scrubbing and to dry their hands with a conventional paper towel. The research assistant will open the opaque envelope, which will indicate that the participant needs to dry their hands with two surgical towels, one for each hand. Receives: Other: Drying procedure after surgical handwashing |
What is being measured
The primary outcome is the main question the study is designed to answer.
Contamination
Presence or absence of fluorescent cream on the upper extremities will be evaluated using a UV light lamp in a dark room. If fluorescence is observed in the washed area where it was not applied, it will be considered that there was contamination during the hand drying process.
Measured: 3 minutes after handwash and hand drying.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 May 2024
- Study start26 Apr 2024
- Primary completion30 Dec 2024 (estimated)
- Study completion30 Jun 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (11)Papers the sponsor has linked to this study.
- Other trials for Hand HygieneStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Investigator, Outcomes assessor
- Enrolment
- 72 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Instituto de Ortopedia Infantil Roosevelt
- Sponsor type
- University, hospital or other
- Collaborators
- Hospital Universitario San Ignacio, Hospital Militar Central, Argentina
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06420934
- Sponsor's protocol ID
- 2022121502-001
- Status last verified
- Oct 2024
- First submitted
- 15 May 2024
- Last updated
- 2 Oct 2024
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care Is Safer Care. Geneva: World Health Organization; 2009. Available from http://www.ncbi.nlm.nih.gov/books/NBK144013/
PubMed 23805438Nicolay CR. Hand hygiene: an evidence-based review for surgeons. Int J Surg. 2006;4(1):53-65. doi: 10.1016/j.ijsu.2005.06.002. Epub 2005 Aug 1.
PubMed 17462314Huang C, Ma W, Stack S. The hygienic efficacy of different hand-drying methods: a review of the evidence. Mayo Clin Proc. 2012 Aug;87(8):791-8. doi: 10.1016/j.mayocp.2012.02.019. Epub 2012 May 31.
PubMed 22656243Gustafson DR, Vetter EA, Larson DR, Ilstrup DM, Maker MD, Thompson RL, Cockerill FR 3rd. Effects of 4 hand-drying methods for removing bacteria from washed hands: a randomized trial. Mayo Clin Proc. 2000 Jul;75(7):705-8. doi: 10.4065/75.7.705.
PubMed 10907386Suen LKP, Lung VYT, Boost MV, Au-Yeung CH, Siu GKH. Microbiological evaluation of different hand drying methods for removing bacteria from washed hands. Sci Rep. 2019 Sep 24;9(1):13754. doi: 10.1038/s41598-019-50239-4.
PubMed 31551459Mutters R, Warnes SL. The method used to dry washed hands affects the number and type of transient and residential bacteria remaining on the skin. J Hosp Infect. 2019 Apr;101(4):408-413. doi: 10.1016/j.jhin.2018.12.005. Epub 2018 Dec 8.
PubMed 30537524Handaya AY, Werdana VAP. Adherence to preoperative hand hygiene and sterile gowning technique among consultant surgeons, surgical residents, and nurses: a pilot study at an academic medical center in Indonesia. Patient Saf Surg. 2019 Mar 11;13:11. doi: 10.1186/s13037-019-0193-5. eCollection 2019.
PubMed 30899331Skodova M, Garcia Urra F, Gimeno Benitez A, Jimenez Romano MR, Gimeno Ortiz A. Hand hygiene assessment in the workplace using a UV lamp. Am J Infect Control. 2015 Dec 1;43(12):1360-2. doi: 10.1016/j.ajic.2015.07.003. Epub 2015 Aug 18.
PubMed 26297523Szilagyi L, Lehotsky A, Nagy M, Haidegger T, Benyo B, Benyo Z. Stery-hand: A new device to support hand disinfection. Annu Int Conf IEEE Eng Med Biol Soc. 2010;2010:4756-9. doi: 10.1109/IEMBS.2010.5626377.
PubMed 21096021Sakmen KD, Sterz J, Stefanescu MC, Zabel J, Lehmann M, Ruesseler M. Impact of the teaching method of the rub-in technique for learning hygienic hand disinfection in medical studies: a comparative effectiveness analysis of two techniques. GMS Hyg Infect Control. 2019 Nov 13;14:Doc17. doi: 10.3205/dgkh000332. eCollection 2019.
PubMed 31815090Marena C, Lodola L, Zecca M, Bulgheroni A, Carretto E, Maserati R, Zambianchi L. Assessment of handwashing practices with chemical and microbiologic methods: preliminary results from a prospective crossover study. Am J Infect Control. 2002 Oct;30(6):334-40. doi: 10.1067/mic.2002.125809.
PubMed 12360141
Study at a glance
From the registry record, last updated by the sponsor on 2 Oct 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of the Breach of the Aseptic Barrier After Surgical Handwashing: Drying With One or Two Surgical Towels
- ClinicalTrials.gov ID
- NCT06420934
- Acronym / sponsor ID
- 2022121502-001
- Keywords
- Surgical Scrubbing, Handwashing, Disinfection, Healthcare Associated Infection, Hand Hygiene
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 72 participants (estimated)
- Lead sponsor
- Instituto de Ortopedia Infantil RooseveltUniversity, hospital or other
- Collaborators
- Hospital Universitario San Ignacio, Hospital Militar Central, Argentina
- Study start
- 26 Apr 2024 (actual)
- Primary completion
- 30 Dec 2024 (estimated)
- Study completion
- 30 Jun 2025 (estimated)
- First posted
- 20 May 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study aims to determine whether the use of two sterile towels for drying after surgical handwashing results in fewer contamination events compared to the use of only one towel among healthcare personnel. This randomized, multicenter, superiority-controlled trial will enroll up to 72 healthcare workers and surgical residents from three hospitals in Bogotá, Colombia. A fluorescent product will simulate bacteria, and contamination will be assessed by evaluating the presence of fluorescent cream after hand drying technique with either two or one surgical sterile towel. Data will be collected through REDCap and deidentified. Differences in the proportion of contamination between the two groups will be assessed using an exact Fischer test, and confounding variables will be included in the analysis through logistic multivariate regression, with a significance level set a priori at 0.05. Results will be submitted for publication in a peer-reviewed journal.
Detailed description
Approval was obtained from the ethics committee of three healthcare institutions. A process of informed consent will be conducted with all participants, and confidentiality and data protection will be guaranteed. A research assistant, unaware of the operational hypotheses and study objectives, will execute the experiment and record the results. There will be no blinding of the intervention for the participants or the assistant. At each institution, randomization will be conducted a priori to determine the operating room where participants should be recruited. Likewise, the intervention to be administered will be randomized. All these data will be stored in opaque envelopes that will be opened at the time of recruitment. A total of 72 participants will be recruited, with 36 exposed to drying with one towel and 36 to drying with two towels. Recruitment will cease upon completion of the respective participants stipulated for each intervention.
The primary outcome of interest will be the presence or absence of contamination. To evaluate this outcome, the gold standard would be the collection of cultures and the analysis of the presence or absence of bacterial contamination. However, due to the costs and methodological difficulties of taking cultures, an indirect method, previously validated as a surrogate, will be employed instead. 2 mL of fluorescent cream (Glo Germ ™) will be applied with a brush proximal to the normally washed area during surgical scrubbing (3 cm above the elbow). Participants will be shown a video on how to dry with one or two surgical towels and will be given one minute to do so. Subsequently, the presence or absence of fluorescent cream on the upper extremities will be evaluated using a UV light lamp. If fluorescence is evidenced in the washed area where it was not applied, it will be considered that there was contamination during the hand drying process.
No interim analyses will be executed. Data will be de-identified for the analysis. Descriptive statistics will be conducted using R studio, and proportions of contamination when drying with one or two towels will be compared. A simple logistic regression will be performed to assess the relationship between the intervention and the proportion of contamination events, and a multivariate logistic regression will be conducted to assess the effect of confounding variables on the outcome. The results will be reported collectively for publication in a peer-reviewed journal.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| One surgical towel | Active comparator | Other: Drying procedure after surgical handwashingParticipants will be asked to remove all accessories from the forearm, wrist, fingers and to roll up any clothing until at least 5 cm above the humeral condyles are exposed. They will be instructed to perform conventional surgical scrubbing and to dry their hands with a conventional paper towel. The research assistant will open the opaque envelope, which will indicate that the participant needs to dry their hands with one surgical towel. |
| Two surgical towel | Experimental | Other: Drying procedure after surgical handwashingParticipants will be asked to remove all accessories from the forearm, wrist, fingers and to roll up any clothing until at least 5 cm above the humeral condyles are exposed. They will be instructed to perform conventional surgical scrubbing and to dry their hands with a conventional paper towel. The research assistant will open the opaque envelope, which will indicate that the participant needs to dry their hands with two surgical towels, one for each hand. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- Workers and students who have a current affiliation with the institutions where the study will be executed.
- Workers and students whose practice or work involves performing surgical handwashing at least once a week for invasive procedures.
Key exclusion criteria (8 listed)
- Workers and students who do not wish to participate in the study.
- Workers and students whose work activities do not allow them time to participate in the study.
- Workers and students who are allergic to the fluorescent cream
- Workers and students whose nails exceed a length of 0.5 cm from the fingertip edge.
- Workers and students whose nails are painted with polish.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Drying procedure after surgical handwashingParticipants will dry their hands with one surgical towel | Other | One surgical towel, Two surgical towel |
Primary outcome
Contamination
Time frame: 3 minutes after handwash and hand drying.
Presence or absence of fluorescent cream on the upper extremities will be evaluated using a UV light lamp in a dark room. If fluorescence is observed in the washed area where it was not applied, it will be considered that there was contamination during the hand drying process.
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Oct 2024.
- Background: PubMed 23805438WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care Is Safer Care. Geneva: World Health Organization; 2009. Available from http://www.ncbi.nlm.nih.gov/books/NBK144013/
- Background: PubMed 17462314Nicolay CR. Hand hygiene: an evidence-based review for surgeons. Int J Surg. 2006;4(1):53-65. doi: 10.1016/j.ijsu.2005.06.002. Epub 2005 Aug 1.
- Background: PubMed 22656243Huang C, Ma W, Stack S. The hygienic efficacy of different hand-drying methods: a review of the evidence. Mayo Clin Proc. 2012 Aug;87(8):791-8. doi: 10.1016/j.mayocp.2012.02.019. Epub 2012 May 31.
- Background: PubMed 10907386Gustafson DR, Vetter EA, Larson DR, Ilstrup DM, Maker MD, Thompson RL, Cockerill FR 3rd. Effects of 4 hand-drying methods for removing bacteria from washed hands: a randomized trial. Mayo Clin Proc. 2000 Jul;75(7):705-8. doi: 10.4065/75.7.705.
- Background: PubMed 31551459Suen LKP, Lung VYT, Boost MV, Au-Yeung CH, Siu GKH. Microbiological evaluation of different hand drying methods for removing bacteria from washed hands. Sci Rep. 2019 Sep 24;9(1):13754. doi: 10.1038/s41598-019-50239-4.
- Background: PubMed 30537524Mutters R, Warnes SL. The method used to dry washed hands affects the number and type of transient and residential bacteria remaining on the skin. J Hosp Infect. 2019 Apr;101(4):408-413. doi: 10.1016/j.jhin.2018.12.005. Epub 2018 Dec 8.
- Background: PubMed 30899331Handaya AY, Werdana VAP. Adherence to preoperative hand hygiene and sterile gowning technique among consultant surgeons, surgical residents, and nurses: a pilot study at an academic medical center in Indonesia. Patient Saf Surg. 2019 Mar 11;13:11. doi: 10.1186/s13037-019-0193-5. eCollection 2019.
- Background: PubMed 26297523Skodova M, Garcia Urra F, Gimeno Benitez A, Jimenez Romano MR, Gimeno Ortiz A. Hand hygiene assessment in the workplace using a UV lamp. Am J Infect Control. 2015 Dec 1;43(12):1360-2. doi: 10.1016/j.ajic.2015.07.003. Epub 2015 Aug 18.
- Background: PubMed 21096021Szilagyi L, Lehotsky A, Nagy M, Haidegger T, Benyo B, Benyo Z. Stery-hand: A new device to support hand disinfection. Annu Int Conf IEEE Eng Med Biol Soc. 2010;2010:4756-9. doi: 10.1109/IEMBS.2010.5626377.
- Background: PubMed 31815090Sakmen KD, Sterz J, Stefanescu MC, Zabel J, Lehmann M, Ruesseler M. Impact of the teaching method of the rub-in technique for learning hygienic hand disinfection in medical studies: a comparative effectiveness analysis of two techniques. GMS Hyg Infect Control. 2019 Nov 13;14:Doc17. doi: 10.3205/dgkh000332. eCollection 2019.
- Background: PubMed 12360141Marena C, Lodola L, Zecca M, Bulgheroni A, Carretto E, Maserati R, Zambianchi L. Assessment of handwashing practices with chemical and microbiologic methods: preliminary results from a prospective crossover study. Am J Infect Control. 2002 Oct;30(6):334-40. doi: 10.1067/mic.2002.125809.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Drying procedure after surgical handwashing in people with Hand Hygiene and Surgical Wound Infection, run by Instituto de Ortopedia Infantil Roosevelt at 1 site in Colombia.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 2 Oct 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Colombia. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Monica Botero-Bermúdez, MD, MSc (+573203049826, monica.botero@javeriana.edu.co), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Contamination (time frame: 3 minutes after handwash and hand drying.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06420934, which also lists 11 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Oct 2024.