PRACTICAL DIRECTIONS FOR DISINFECTION. 205 



DISINFECTION OF THE HANDS. 



The importance of a reliable method of disinfecting the hands of 

 surgeons, obstetricians, and nurses after they have been in contact 

 with infectious material from wounds, puerperal discharges, etc. , is 

 now fully recognized, and some surgeons consider it necessary to 

 completely sterilize the hands before undertaking any surgical opera- 

 tion which will bring them in contact with the freshly-cut tissues. 

 The numerous experiments which have been made with a view to 

 ascertaining the best method of accomplishing such sterilization of 

 the hands show that it is by no means a simple matter to effect it, 

 and especially to insure the destruction of microorganisms con- 

 cealed beneath the finger nails. Fiirbringer, in an extended series 

 of experiments (1888), found that a preliminary cleansing with soap 

 and a brush was even more important than the degree of potency of 

 the disinfecting wash subsequently applied. He recommends the 

 following procedure : 



1. Remove all visible dirt from beneath and around the nails. 



2. Brush the spaces beneath the nails with soap and hot water 

 for a minute. 



3. Wash for a minute in alcohol (not below eighty per cent), and, 

 before this evaporates, in the following solution : 



4. Wash thoroughly for a minute in a solution containing 1 : 500 

 of mercuric chloride or three per cent of carbolic acid. 



Roux and Reynes tested the above method of Fiirbringer, and 

 found that it gave better results than others previously proposed, al- 

 though not always entirely successful in securing complete steriliza- 

 tion. 



Boll has recently (1890) reported favorable results from the fol- 

 lowing method : 



1. Cleanse the finger nails from visible dirt with knife or nail scissors. 



2. Brush the hands for three minutes with hot water and potash soap. 



3. Wash for half a minute in a three-per-cent solution of carbolic acid, 

 and subsequently in a 1 : 2,000 solution of mercuric chloride. 



4. Rub the spaces beneath the nails and around their margins with iodo- 

 form gauze wet in a five-per-ceut solution of carbolic acid. 



Welch, as a result of extended experiments made at the Johns 

 Hopkins Hospital, recommends the following procedure : 



1. The nails are kept short and clean. 



2. The hands are washed thoroughly for several minutes with soap and 

 water, the water being as warm as can be comfortably borne, and being fre- 

 quently changed. A brush sterilized by steam is used. The excess of soap 

 is washed off with water. 



3. The hands are immersed for one or two minutes in a warm saturated 

 solution of permanganate of ootash and are rubbed over thoroughly with a 

 sterilized swab. 



