BACKGROUND Viruses significantly contribute to outbreaks in healthcare facilities, primarily through direct or indirect hand contact. Consequently, hand disinfection using hygienic hand rubs is a pivotal measure for preventing nosocomial virus infections in medical environments. In 2024, the EN 17430 standard was introduced as the first method to evaluate the virucidal efficacy of hand disinfectants under practical conditions. The new method offers an advantage over suspension tests (e.g., EN 14476) by enabling the assessment of hand rubs using human volunteers. This study aims to compare the results of these two methods by investigating the in vivo efficacy of various ethanol formulations and two commercially available alcohol mixtures against human adenovirus type 5 (AdV-5). METHODS The in vivo efficacy of pure Ethanol formulations in concentrations from 60% to 97% and two alcohol mixtures (M1: 45 % ethanol and 18 % 1-propanol; M2: 45% 2-propanol and 30% 1-propanol) were evaluated on the hands of 5 or 20 volunteers, utilizing a cross-over study design based on EN 17430. RESULTS With the different ethanol formulations increasing reduction factors with higher alcohol concentrations were detected. Of the two alcohol-containing mixtures, only M1 demonstrated efficacy based on the requirements of EN 17430, the second formulation M2, however, narrowly failed effectiveness. DISCUSSION In conclusion, results from suspension tests with AdV-5 were not directly transferable to those obtained with the alcohol formulations tested under practical conditions as per EN 17430.
BACKGROUND Surgical-site infection (SSI) is a major source of morbidity after elective open abdominal surgery. Prophylactic negative-pressure wound therapy (NPWT) may reduce SSI, but evidence specific to elective surgery remains limited. METHODS PubMed, Embase, CENTRAL, Scopus, and Web of Science were searched through June 2026 for RCTs comparing prophylactic NPWT with standard wound dressing (SWD) in adults undergoing elective open abdominal surgery. The prespecified primary outcome was overall SSI within 30 days. Random-effects (REML) meta-analysis generated risk ratios or mean differences with 95% confidence and prediction intervals; certainty was assessed using GRADE. RESULTS Sixteen RCTs (2 639 patients) were included; 13 were at low risk of bias. NPWT reduced overall SSI (15 RCTs, 2 134 patients; RR 0.60, 95% CI 0.43-0.84; low certainty; absolute risk 12.6% vs 19.5%, approximately 7% reduction; NNT≈15), superficial SSI (RR 0.58, 95% CI 0.35-0.98), and seroma (RR 0.57, 95% CI 0.38-0.86; both high certainty). No significant differences were observed in deep SSI, hematoma, dehiscence, readmission, length of stay, blood loss, operative time, or mortality. Benefit was concentrated in lower-income-country trials and high-risk patients, whereas high-income multicenter trials showed no benefit. Prediction intervals crossed the null, and funnel asymmetry suggested possible publication bias. CONCLUSIONS NPWT may reduce overall SSI, superficial SSI, and seroma after elective open abdominal surgery, but effects appear context-dependent and were absent in the highest-quality multicenter trials. Routine use in unselected elective patients is not supported; selective use in high-risk patients may be appropriate, pending confirmatory trials such as PROPEL-2.
