Rub-in procedure using alcohol-based hand disinfectants before surgical procedures and before putting on sterile surgical gloves to eliminate transient skin flora and reduce resident skin flora as much as possible. Prior to the first surgical hand disinfection on the day of surgery, a short handwash is recommended to reduce spores on the hands. The rub-in procedure consists of disinfecting the hands, then the forearms up to the elbows and finally the hands again. Hands should be dry before putting on surgical gloves, as this reduces both the rate of perforation and the risk of skin irritation. Generally, the rub-in time is 1.5 minutes. In Europe, efficacy testing is done in vivo according to EN 12791 that requires the test product’s reduction of microorganisms —measured in log10 steps —to not be significantly lower than the result of the reference procedure. This applies to both the immediate value and the 3-hour value on the gloved hand.
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