Is sterility essential for hand-drying products in surgical hand antisepsis? A controlled before-and-after study

Tingting Zhang; Qin Qin; Ruoyu Cao; Renqiang Lu; Dongxue Li

doi:10.1016/j.ajic.2025.07.002

Is sterility essential for hand-drying products in surgical hand antisepsis? A controlled before-and-after study

Am J Infect Control. 2025 Jul 9:S0196-6553(25)00462-6. doi: 10.1016/j.ajic.2025.07.002. Online ahead of print.

Authors

Tingting Zhang¹, Qin Qin¹, Ruoyu Cao², Renqiang Lu¹, Dongxue Li³

Affiliations

¹ Operating Room, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
² Nursing Department, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
³ Operating Room, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China. Electronic address: 300925@hospital.cqmu.edu.cn.

PMID: 40645292
DOI: 10.1016/j.ajic.2025.07.002

Abstract

Background: Using sterile hand-drying products for surgical hand antisepsis incurs high economic and labor costs.

Aim: This study assesses the effectiveness and cost-efficiency of clean paper towels, sterile cloth towels, and sterile paper towels for surgical hand antisepsis.

Methods: In March 2024, a controlled study was conducted with 50 medical volunteers from the Second Affiliated Hospital of Chongqing Medical University. The study compared bacterial cultures on hands after drying with different products and using a rinse-free hand disinfectant, while also calculating the hand-drying cost per surgical procedure.

Findings: Colony counts from hand bacterial cultures after drying with clean paper towels, sterile cloth towels, and sterile paper towels were 0.01 (0.00, 0.18) CFU/cm², 0.30 (0.05, 0.77) CFU/cm², and 0.01 (0.00, 0.08) CFU/cm², with a significant difference (p < 0.001). After using rinse-free hand disinfectant, counts were 0.00 CFU/cm² for all methods, with no significant difference (p > 0.05). Total bacterial colonies were below 5 CFU/cm², meeting surgical hand antisepsis standards. All products had a 100% qualification rate, with costs of 0.20 RMB for clean paper towels, 5.70 RMB for sterile cloth towels, and 8.20 RMB for sterile paper towels.

Conclusion: Clean paper towels are more effective at reducing hand bacteria and more cost-efficient than sterile hand-drying products, making them ideal for reducing operating costs and widely applicable in medical institutions.

Keywords: Clean paper towel; Hand bacterial culture; Hand-drying product; Sterile cloth towel; Sterile paper towel; Surgical hand antisepsis.