Estudio comparativo sobre la higiene de manos prequirúrgica con solución hidroalcohólica frente a la higiene prequirúrgica tradicional / Comparative study of presurgical hand hygiene with hydroalcoholic solution versus traditional presurgical hand hygiene

Objetivo: Comparar la higiene de manos prequirúrgica con solución hidroalcohólica siguiendo el protocolo de la OMS con la higiene de manos prequirúrgica tradicional. Método: Se realizaron cultivos de las manos de cirujanos y enfermeros quirúrgicos antes y después de la higiene de manos prequirúrgica y tras la retirada de los guantes al acabar la cirugía. Los cultivos se hicieron en 2 días diferentes: el primero tras la higiene de manos prequirúrgica tradicional y el segundo tras la higiene de manos prequirúrgica con solución hidroalcohólica siguiendo el protocolo de la OMS. Se cronometró el tiempo de realización de la higiene de manos tradicional y se comparó con los 3 min del protocolo de la OMS. El coste de los productos usados para la técnica tradicional se comparó con el coste de la solución hidroalcohólica utilizada. La variabilidad de la técnica tradicional se obtuvo observando a cada participante en el estudio durante su realización. Resultados: Tras la higiene prequirúrgica con solución hidroalcohólica se detectaron unidades formadoras de colonias (UFC) en 5 sujetos (7,3%) mientras que tras la higiene prequirúrgica tradicional, se detectaron UFC en 14 sujetos (20,5%) (p<0,05). Tras la retirada de los guantes, el recuento de UFC fue similar (p<0,7). El tiempo de realización de la higiene con solución hidroalcohólica (3 min) fue inferior al de la higiene tradicional (p<0,05), su coste fue la mitad y se eliminó la variabilidad. Conclusiones: Comparada con otras técnicas, la higiene de manos prequirúrgica con solución hidroalcohólica disminuye de forma significativa las UFC, se acompaña de un tiempo de latencia similar, tiene menor coste y ahorra tiempo (AU)

Objective: To compare presurgical hand hygiene with hydroalcoholic solution following the WHO protocol with traditional presurgical hand hygiene. Methods: Cultures of the hands of surgeons and surgical nurses were performed before and after presurgical hand hygiene and after removing gloves at the end of surgery. Cultures were done in 2different days: the first day after traditional presurgical hand hygiene, and the second day after presurgical hand hygiene with hydroalcoholic solution following the WHO protocol. The duration of the traditional hand hygiene was measured and compared with the duration (3min) of the WHO protocol. The cost of the products used in the traditional technique was compared with the cost of the hydroalcoholic solution used. The variability of the traditional technique was determined by observation. Results: Following presurgical hand hygiene with hydroalcoholic solution, colony-forming units (CFU) were detected in 5 (7.3%) subjects, whereas after traditional presurgical hand hygiene CFU were detected in 14 subjects (20.5%) (p < 0.05). After glove removal, the numbers of CFU were similar. The time employed in hand hygiene with hydroalcoholic solution (3min) was inferior to the time employed in the traditional technique (p < 0.05), its cost was less than half, and there was no variability. Conclusions: Compared with other techniques, presurgical hand hygiene with hydroalcoholic solution significantly decreases CFU, has similar latency time, a lower cost, and saves time (AU)

Comparative study of presurgical hand hygiene with hydroalcoholic solution versus traditional presurgical hand hygiene. / Estudio comparativo sobre la higiene de manos prequirúrgica con solución hidroalcohólica frente a la higiene prequirúrgica tradicional.

OBJECTIVE: To compare presurgical hand hygiene with hydroalcoholic solution following the WHO protocol with traditional presurgical hand hygiene. METHODS: Cultures of the hands of surgeons and surgical nurses were performed before and after presurgical hand hygiene and after removing gloves at the end of surgery. Cultures were done in 2different days: the first day after traditional presurgical hand hygiene, and the second day after presurgical hand hygiene with hydroalcoholic solution following the WHO protocol. The duration of the traditional hand hygiene was measured and compared with the duration (3min) of the WHO protocol. The cost of the products used in the traditional technique was compared with the cost of the hydroalcoholic solution used. The variability of the traditional technique was determined by observation. RESULTS: Following presurgical hand hygiene with hydroalcoholic solution, colony-forming units (CFU) were detected in 5 (7.3%) subjects, whereas after traditional presurgical hand hygiene CFU were detected in 14 subjects (20.5%) (p < 0.05). After glove removal, the numbers of CFU were similar. The time employed in hand hygiene with hydroalcoholic solution (3min) was inferior to the time employed in the traditional technique (p < 0.05), its cost was less than half, and there was no variability. CONCLUSIONS: Compared with other techniques, presurgical hand hygiene with hydroalcoholic solution significantly decreases CFU, has similar latency time, a lower cost, and saves time.

Traumatismos menores de la extremidad inferior, enfermedad tromboembólica venosa y trombofilia / Minor trauma of the lower limbs, venous throum-boemblic disease and thrombophilia

En los pacientes con traumatismos menores de la extremidad inferior no se recomienda instaurar tromboprofilaxis de forma sistemática. Se revisaron las características clínicas y la presencia de trombofilia en estos casos. Método: Estudio retrospectivo de casos de enfermedad tromboembólica venosa tras traumatismos menores de la extremidad inferior. Resultados: Entre marzo de 2001 y marzo de 2006, se diagnosticaron 21 casos de enfermedad tromboembólica venosa tras traumatismos menores de la extremidad inferior. Veinte pacientes presentaron trombosis venosa profunda (TVP); hubo dos casos de tromboembolismo pulmonar. En 10 (71%) de los 14 pacientes que participaron en el estudio de trombofilia se encontraron alteraciones. Conclusiones: Los traumatismos menores de la extremidad inferior constituyen un factor de riesgo para el desarrollo de enfermedad tromboembólica venosa. En este tipo de traumatismos debe considerarse la posibilidad de instaurar tromboprofilaxis. El diagnóstico de trombofilia debe de tenerse en cuenta cuando se desarrolla enfermedad tromboembólica venosa tras traumatismos menores de la extremidad inferior (AU)

Background: In patients with minor trauma of the lower limbs, no systematic thrombopeophylaxis is recommended. We have reviewed the clinical features and the presence of thrombophilia in such cases. Method: Retrospective study of cases of venous thromboembolic disease after minor trauma of the lower limbs. Results: Twenty-one cases of venous thromboembolic disease following minor trauma to the lower limbs were diagnosed between March 2001 and March 2006. Twenty patients had deep venous thrombosis, with two cases of pulmonary embolism. Some abnormality was detected in 10 (71%) of the 14 patients participating in the thrombophilia study. Conclusions: Minor trauma to the lower limbs represents a risk factor for the development of venous thromboembolic disease. The possibility to initiate thromboprophylaxis should therefore be considered in this setting. Thrombophilia should be considered and ruled out when venous thromboembolic disease develops following minor trauma to the lower limbs (AU)