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To the Editor: Dr Parienti and colleagues¹ found that hand-rubbing with an aqueous alcoholic solution was as effective as traditional surgical hand-scrubbing in preventing surgical site infections (SSI).

This type of study is difficult to perform because SSI rates are low and therefore a very large number of patients would be required to find a difference in infection rates. In this randomized but nonblinded study, 4387 patients were studied based on a power analysis assuming an SSI rate of 4%. However, the results showed an SSI rate of only 2.46%, a result similar to other studies cited by the authors. Indeed, the authors could not cite any studies with an SSI rate of 4% for routine surgery. Therefore, their power analysis was incorrect and the result showing no statistically significant difference may simply be a type 2 error due to an insufficient number of patients studied.

The group using the . . . [Full Text of this Article]

Jean Jacques Parienti, MD, DTM&H
Departments of Infectious Diseases and Intensive Care Unit, Hygiene, and Public Health

Pascal Thibon, MD; Xavier Le Coutour, MD
Departments of Hygiene and Public Health

Yannick Le Roux, MD, DCh
Department of Abdominal Surgery

Henri Bensadoun, MD, DCh
Department of Urology

Peter von Theobald, MD, DCh
Department of Gynaecology and Obstetrics
Côte de Nacre University Hospital Centre
Caen, France

Remy Heller, PharmD, PhD
Department of Hygiene
General Hospital
Colmar, France
for Members of the Antisepsie Chirurgicale des Mains Study Group