Timsit JF, Mimoz O, Mourvillier B, et al. Randomized Controlled Trial of Chlorhexidine Dressing and Highly Adhesive Dressing for Preventing Catheter-related Infections in Critically Ill Adults. Am J Respir Crit Care Med. 2012 Dec 15;186(12):1272-8. doi: 10.1164/rccm.201206-1038OC. Epub 2012 Oct 4. (Original) PMID: 23043083
RCT demonstrates benefit
surg face masks if close (<30cm) or you are talking. If you are not wearing one and must talk, turn 90 degrees from the field. (Anaesthesia 1998;53:624-626)
British Journal of Anaesthesia, 1992, Vol. 69, No. 4 407-408 © 1992 The Board of Management and Trustees of the British Journal of Anaesthesia research-article SURGICAL FACE MASKS ARE EFFECTIVE IN REDUCING BACTERIAL CONTAMINATION CAUSED BY DISPERSAL FROM THE UPPER AIRWAY B.J. PHILIPS, M.B., B.S., S. FERGUSSON, F.I.M.L.S., P. ARMSTRONG, F.R.C.ANAES., F.M. ANDERSON, M.R.C.PATH. and J. A. W. WILDSMITH, M.D., F.R.C.ANAES. Department of Anaesthetics, Royal Infirmary of Edinburgh Lauriston Place, Edinburgh EH3 9YW. Department of Medical Microbiology, Medical School Teviot Place, Edinburgh EH8 9AG We have studied the effectiveness of surgical face masks in reducing bacterial contamination of a surface, produced by dispersal of organisms from the upper airway. Twenty-five volunteers were asked to speak at blood agar plates positioned in close proximity to the mouth, initially whilst not wearing a face mask and then wearing a surgical face mask over the mouth and nose. A fresh face mask almost completely abolished bacterial contamination of agar plates 30 cm from the mouth. After 15 min there was an increase in the level of contamination which was statistically insignificant.
Applying a skin preparation with concentric circles
is the best method.
There is no evidence that supports the concentric circular application methodology.1 Human skin varies markedly over different parts of the body. Because 80% of transient skin flora resides in the first five cell layers of skin, it is important to reach those lower layers and kill the potential pathogens dwelling further down. In addition to having multiple layers, the skin contains many cracks and crevices where organisms reside. Overall, these factors contribute to differential adherence and accessibility of microbes.(1-8) This suggests that in order to reach, properly dislodge, and kill potentially dangerous microbes, scrubbing, as opposed to uniformly, circular application, may be preferable.(1-2) The back-and-forth action creates friction and helps drive the solution into crevices and lower layers, killing more bacteria. Regardless of the cutaneous antiseptic used, allowing the preparation to dry completely is important to maximum effectiveness.
(1) AACN. 2005;22(10) (Available at aacn.org : click here)(2) AORN. 2003; Standards, Recommended Practices, and Guidelines. pp. 338-341. (3) Pfaff SJ Plast Surg Nurs. 2005;25(3):140-9; quiz 150-1. (4) Keblish DJ et al. J Bone Joint Surg Am. 2005;87:986-992. (5) Ryder M (Available at invectioncontroltoday.com: click here)(6) Salvi M et al. Knee Surg Sports Traumatol Arthrosc. 2006;14(1):27-31. Epub 2005 Jul 30.(7) Nielsen ML et al. J Clin Pathol. 1975;28(10):793-7.(8) Brooks RA et al. Foot Ankle Int. 2001;22(4):347-50.
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