Prospective, randomised clinical trial of four different presurgical hand antiseptic techniques in equine surgery.

Summary

# Editorial Summary Equine surgical protocols have lagged behind human medicine in adopting evidence-based hand antisepsis techniques, with most equine surgeons continuing traditional soap-and-brush protocols despite WHO recommendations favouring alcohol-based hand rubs (ABR). Biermann and colleagues conducted a prospective randomised controlled trial comparing four presurgical hand preparation methods: chlorhexidine scrubbing, chlorhexidine rubbing, ABR alone, and ABR combined with chlorhexidine—measuring bacterial colony counts from surgeons' hands before preparation, immediately after, and at intervals during surgery. The study demonstrated that rubbing techniques, whether with chlorhexidine or ABR, achieved comparable antimicrobial efficacy to traditional scrubbing whilst causing significantly less skin irritation, and ABR protocols met or exceeded the antimicrobial performance of chlorhexidine-based preparations. These findings support a shift towards gentler, alcohol-based or rubbing-based hand antisepsis in equine theatre, potentially reducing cumulative dermatological damage to surgical staff whilst maintaining the sterile field—particularly valuable given the extended surgical procedures common in equine practice and the occupational burden on surgical teams.

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Key Findings

• •Study compares four presurgical hand antiseptic techniques in equine surgery
• •Evaluated scrubbing vs. rubbing technique with disinfecting soaps
• •Assessed alcohol-based hand rubs (ABR) versus chlorhexidine-based products
• •WHO recommends ABR for human surgery but most equine surgeons still use disinfecting soap

Conditions Studied

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