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Related Concept Videos

Hand hygiene01:23

Hand hygiene

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Asepsis is the practice of preventing or breaking the chain of infection. The nurse employs aseptic techniques to prevent the spread of microorganisms and reduce the risk of diseases. Hand hygiene is the cornerstone of aseptic techniques and is classified into medical and surgical asepsis. Medical asepsis includes hand hygiene and the use of gloves. Surgical asepsis, or the sterile technique, refers to practices that render and keep objects and areas free of microorganisms.
Hand washing...
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Handwashing II: Pre-procedure and Initial Procedure Steps01:19

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The pre-procedure steps of handwashing include removing jewelry and rolling up sleeves. However, many organizations allow staff to wear wedding rings.
The hand washing procedure itself includes the following steps. First, cover cuts, if any, on hands with a waterproof dressing. Cuts and abrasions can become contaminated with bacteria hindering the ability to clean the area thoroughly. In addition, repeated hand washing can worsen an injury.  The nails must be short and clean, without nail...
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Standard Precaution01:26

Standard Precaution

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Standard precautions are the minimum infection control safeguards used while caring for all patients, irrespective of their disease condition. They help prevent the spread of common infectious microorganisms to healthcare workers, patients, and visitors in all healthcare settings.
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
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Handwashing III: During the Procedure and Post-Procedure Steps01:15

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To wash hands properly, follow these steps:
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Factors Affecting the Risk of Infection01:26

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The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
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Healthcare Associated Infections II: Preventive Measures01:22

Healthcare Associated Infections II: Preventive Measures

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Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
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Related Experiment Video

Updated: Sep 15, 2025

A Method to Test the Efficacy of Handwashing for the Removal of Emerging Infectious Pathogens
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Esmarch Exsanguination in Acute Hand Infections: Evaluating Risk of Infection Spread.

Jacob Zeitlin1,2, Sebastian D Arango1,3, Jason C Flynn1,4

  • 1Philadelphia Hand to Shoulder Center, Philadelphia, Pennsylvania, USA.

Surgical Infections
|July 15, 2025
PubMed
Summary

Esmarch exsanguination for acute hand infections did not increase infection complications compared to gravitational methods. This study suggests surgeons can consider Esmarch for better visualization without significant infection risk.

Keywords:
Esmarchcomplicationsexsanguinationhand infectiontourniquet

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Area of Science:

  • Orthopedics
  • Infectious Disease
  • Surgical Techniques

Background:

  • Acute hand and forearm infections require prompt surgical intervention, often involving irrigation and debridement (I&D).
  • Exsanguination techniques are used to minimize blood loss and improve surgical field visualization.
  • The safety of Esmarch exsanguination in the context of active infection has been a historical concern.

Purpose of the Study:

  • To compare infection-related complication rates between Esmarch exsanguination and gravitational exsanguination in patients with acute hand/forearm infections.
  • To evaluate the impact of Esmarch exsanguination on repeat I&D, hematological spread, and 30-day readmission rates.

Main Methods:

  • Retrospective cohort study of 80 adult patients undergoing I&D for acute hand/forearm infections.
  • Patients were divided into Esmarch exsanguination (n=33) and non-Esmarch (gravitational) (n=47) groups.
  • Infection-related complications, including repeat I&D, hematological spread, and 30-day readmission, were compared using Fisher exact test.

Main Results:

  • Overall complication rates were 15.2% (Esmarch) vs. 8.5% (non-Esmarch).
  • Repeat I&D rates were 12.1% (Esmarch) vs. 6.4% (non-Esmarch).
  • No statistically significant difference in infection-related complications was observed between the groups.

Conclusions:

  • Esmarch exsanguination does not appear to significantly increase infection-related complications in acute hand infections.
  • Findings challenge the traditional contraindication of Esmarch exsanguination in infected extremities.
  • Surgeons may consider Esmarch exsanguination for improved surgical visualization in hand infections without substantial added risk.