Do not perform surgical hand scrubbing with water and antiseptic soap before every procedure; instead, after the first wash of the day, prefer the use of alcohol-based hand rubs, if hands are not visibly contaminated.

May 12, 2026

Do not perform surgical hand scrubbing with water and antiseptic soap before every procedure; instead, after the first wash of the day, prefer the use of alcohol-based hand rubs, if hands are not visibly contaminated.

Type of practice

Other health practices

Age

Adult, Geriatric, Pediatric

Topic Area

Environment

Surgical hand scrubbing has a significant environmental impact, consuming an average of 16-30 litres of water per operator for each wash. World Health Organization (WHO) and National Institute for Health and Care Excellence (NICE) guidelines recommend the “Rub don’t Scrub” protocol: after the first wash of the day with water and antiseptic soap, switch to alcohol-based hand rubs (ABHR) between procedures unless hands are visibly soiled. This drastically reduces water and energy consumption and preparation time (90 seconds instead of 3-5 minutes), while ensuring equal or superior efficacy in decontamination.

Sources

1. World Health Organization. Global guidelines for the prevention of surgical site infection. Geneva, Switzerland: WHO; 2018. (last accessed: April 2026). https://www.who.int/publications/i/item/9789241550475
2. National Institute for Health and Care Excellence. Surgical site infections: prevention and treatment [NG125]. London, UK: NICE; 2019. (last accessed: April 2026). https://www.nice.org.uk/guidance/ng125
3. Ministero della Salute. Linee Guida per l’Igiene delle Mani nell’Assistenza Sanitaria. Roma: Ministero della Salute; 2012.
4. Gasson S, Solari F, Jesudason EP, et al. Sustainable Hand Surgery: Incorporating Water Efficiency Into Clinical Practice. Cureus 2023;15:e38331. doi: CV10.7759/cureus.38331.
5. Olivia C, Ibrahim K, Kurniawan T. Which Surgical Hand Preparation Method Is More Effective? A Comparative Study of Hand Rub and Hand Scrub. Nurs Rep 2025;15:242. doi: 10.3390/nursrep15070242.

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Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.