Brushes and picks used on nails during the surgical scrub to reduce bacteria: a randomised trial.

Though brushes are no longer used on the hands and forearms during the surgical scrub, they are still widely used on the nails. The aim of this study was to determine if nail picks and nail brushes are effective in providing additional decontamination during a surgical hand scrub. One hundred and sixty four operating department staff were randomised to undertake one of the following three surgical hand scrub protocols; chlorhexidine only, chlorhexidine and a nail pick or chlorhexidine and a nail brush. Bacterial hand sampling was conducted before and one hour after scrubbing using a modified version of the glove juice method. No statistically significant differences in bacterial numbers were found between any two of the three intervention groups. Nail brushes and nail picks used during surgical hand scrubs do not decrease bacterial numbers and are unnecessary.