Previous studies evaluated the efficacy of the hydroalcoholic solution of 3% digluconate of chlorhexidine, 0.3% potassium sorbate and 70% ethanol, "Sorbectol" (Spanish patent ES 2 784 275 B2) in the surgical hand preparation with positive results. This clinical trial is focused on optimising the effectiveness of Sorbectol in the surgical hand preparation by scaling the application times of the product from 1 to 5 minutes following the test procedure and the effectiveness criteria of the European norm EN-12791.
This is a randomised clinical trial with a Latin-square crossover design, to test the effectiveness of the Sorbectol solution in surgical hand preparation, according to the EN 12791 standard, at application times of 1, 3 or 5 minutes. The test compares the bacterial load on the hands of at least 23 healthy volunteers immediately (immediate effect) and three hours after (3-hour effect) application of the test product with respect to the reference product, RP, of EN 12791 (n-propanol 60%). Briefly: The bacterial load on hands before antisepsis (pre-values) is obtained after the preparatory handwash using a diluted soft soap. Next, surgical hand antisepsis protocols are performed. Enrolled participants are randomly divided into four groups of the same size to receive RP or Sorbectol for 1 min (P1), 3 min (P2) or 5 min (P3) in parallel in a first run. The test is repeated in a second, third and fourth run changing the antisepsis roles for each group. A washout period of at least 2 weeks between experimental runs allow for the reconstitution of skin microbiota. All participants complete the four antiseptic procedures at the end of the trial. The RP group, rub their hands with n-propanol (60% v/v) for 3 min. The test product groups, rub their hands with Sorbectol for 1 or 3 or 5 min. In all cases applying as many 3 ml portions as necessary to keep the hands moist for the selected time. After antisepsis the bacterial load (post-values) is determined using a split-hands model. One hand to assess the bacterial load immediately after treatment (immediate post-values) and the other hand to assess the bacterial load 3 hours later, keeping the hand gloved in the meantime (3-h post-values).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Propanol hand rub for 3 min. The applied volume of product is sufficient to keep the hand moist for a total time of 3 min, adding as many 3 ml portions as necessary according to EN 12791. According to the EN 1279, the role assigned to each hand (immediate or 3h effect) in the first run is swapped in the subsequent runs.
Sorbectol hand rub for 1 min. The applied volume of product is sufficient to keep the hand moist for a total time of 1 min, adding as many 3 ml portions as necessary according to EN 12791. According to the EN 1279, the role assigned to each hand (immediate or 3h effect) in the first run is swapped in the subsequent runs.
Universidad Complutense de Madrid
Madrid, Spain
RECRUITINGImmediate effect assessed immediately after surgical hand antisepsis
It refers to the reduction in bacterial load (expressed as the decimal logarithm, Log, of colony-forming units per milliliter of sample, CFU/ml) achieved immediately after the application of surgical hand antisepsis in one of the hands. The immediate effect is calculated by using the expression Log CFU/ml of immediate pre-values minus Log CFU/ml of immediate post-values, where the immediate pre-values are the bacterial counts pre-existing on the selected hand for immediate effect before disinfection, at the time point 0, and the immediate post-values are the bacterial counts determined on the same hand after the application of the antiseptic, at the time point 1.This primary outcome measure is used to evaluate the non-inferiority criterium proposed by the EN 12791 for tested antiseptic protocols, P1, P2 and P3 vs. RP.
Time frame: Immediate effect is a measure determined at the time point 1, within the first 10 minutes of disinfection assay. The specific duration is subject to variation based on the particular application protocol of P1, P2, P3 and RP.]
Effect assessed 3-hours after surgical hand antisepsis
It refers to the reduction in bacterial load (expressed as the decimal logarithm, Log, of colony-forming units per milliliter of sample, CFU/ml) achieved 3 hours after of the surgical hand antisepsis on the opposite hand used for immediate effect determination. The 3-hours effect is calculated by using the expression Log CFU/ml of 3-hours pre-values minus Log CFU/ml of 3-hours post-values, where the 3-hours pre-values are the bacterial count pre-existing on the selected hand for 3-hours effect determination before disinfection, at the time point 0, and the 3-hours post-values are the bacterial count determined on the same hand 3-hours after the application of the antiseptic, at the time point 2.This primary outcome measure is used to evaluate the non-inferiority and sustained effect criteria proposed by the EN 12791 for tested antiseptic protocols, P1, P2 and P3 vs. RP.
Time frame: The 3-hours effect is a measure determined at the time point 2 which is 3 hours after the immediate effect determination]
Bacterial counts preexisting on the hands before surgical hand antisepsis. Pre-values.
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Masking
SINGLE
Enrollment
28
Sorbectol hand rub for 3 min. The applied volume of product is sufficient to keep the hand moist for a total time of 3 min, adding as many 3 ml portions as necessary according to EN 12791. According to the EN 1279, the role assigned to each hand (immediate or 3h effect) in the first run is swapped in the subsequent runs.
Sorbectol hand rub for 5 min. The applied volume of product is sufficient to keep the hand moist for a total time of 5 min, adding as many 3 ml portions as necessary according to EN 12791. According to the EN 1279, the role assigned to each hand (immediate or 3h effect) in the first run is swapped in the subsequent runs.
This refers to the bacterial counts (expressed as the decimal logarithm, Log, of colony-forming units per milliliter of sample, CFU/ml) preexisting on the hands before surgical hand antisepsis. Preexisting bacterial counts are determined on each hand, in parallel at the time point 0. The bacterial count determined on one hand is called the immediate pre-value, and the bacterial count determined on the other hand is called the 3-hour pre-value This secondary outcome measure is used to calculate the extension of the immediate and 3-hours effect primary outcome measures for tested antiseptic protocols, P1, P2, P3 and the RP.
Time frame: Prevalues is a measure determined at the time point 0 which represent the beginning of the disinfection assay
Bacterial counts immediately after surgical hand antisepsis. Immediate post-values
It refers to the bacterial count (expressed as the decimal logarithm, Log, of colony-forming units per milliliter of sample, CFU/ml) determined immediately after surgical hand antisepsis. This bacterial count, called the immediate post-value, is determined on the selected hand for immediate effect, at time point 1. This secondary outcome measure is used to calculate the extension of the immediate effect primary outcome measure for tested antiseptic protocols, P1, P2, P3 and the RP.
Time frame: Immediate post-value is a measure determined at the time point 1, within the first 10 minutes of disinfection assay. The specific duration is subject to variation based on the particular application protocol of P1, P2, P3 and RP.]
Bacterial counts 3-hours after surgical hand antisepsis. 3-hours post-values
This refers to the bacterial count (expressed as the decimal logarithm, Log, of colony-forming units per milliliter of sample, CFU/ml) determined 3-hours after surgical hand antisepsis. This bacterial count, called the 3-hours post-value, is determined on the selected hand for 3-hours effect, at time point 2. This secondary outcome measure is used to calculate the extension of the 3-hours effect primary outcome measure for tested antiseptic protocols, P1, P2, P3 and the RP.
Time frame: 3-hours post-value is a measure determined at the time point 2, which is 3 hours after the immediate post-value determination.