Efficacy of Alcohol Hand-rubbing Covering All Hand Surfaces in Reducing Bacterial Hand Contamination of Healthcare Staff
NCT ID: NCT01337856
Last Updated: 2011-04-19
Study Results
Results pending
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.
Recruitment Status
COMPLETED
Clinical Phase
NA
Total Enrollment
120 participants
Study Classification
INTERVENTIONAL
Study Start Date
2007-10-31
Study Completion Date
2008-09-30
Brief Summary
Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.
This is a randomized controlled trial comparing the effectiveness of three hand hygiene protocols, during routine inpatient clinical care: Protocol 1: handrubbing with alcohol covering all hand surfaces in no particular order; Protocol 2: handrubbing with alcohol using the WHO standard 7-step technique; and Protocol 3: handwashing with chlorhexidine using the WHO standard 7-step technique.
The main study hypothesis is that alcohol hand-rubbing covering all hand surfaces is not less effective in reducing bacterial hand contamination of healthcare staff than alcohol hand-rubbing using 7-step technique; and is more effective than chlorhexidine handwashing. The secondary study hypothesis is that time spent on alcohol hand-rubbing covering all hand surfaces is less than that required by the other 2 hand hygiene protocols respectively.
The main study hypothesis is that alcohol hand-rubbing covering all hand surfaces is not less effective in reducing bacterial hand contamination of healthcare staff than alcohol hand-rubbing using 7-step technique; and is more effective than chlorhexidine handwashing. The secondary study hypothesis is that time spent on alcohol hand-rubbing covering all hand surfaces is less than that required by the other 2 hand hygiene protocols respectively.
Related Clinical Trials
Explore similar clinical trials based on study characteristics and research focus.
Randomised Controlled Trial (RCT) of 6 Versus 3 Steps for Hand Hygiene
NCT02396836
Hand Hygiene
COMPLETED
NA
Effectiveness of an Alcohol-based Hand Rub to "Clean" Gloved Hands
NCT03445676
Hand Hygiene
COMPLETED
NA
Hand Hygiene Intervention Study
NCT01933087
Health Care Workers
COMPLETED
NA
Evaluation of Two Hand Hygiene Products in ICUs
NCT02258412
Hand Hygiene Effectiveness
COMPLETED
PHASE4
Simplifying the World Health Organization (WHO) Protocol for Hand Hygiene: Three Steps and 15 Seconds
NCT04102488
Hand Hygiene
COMPLETED
NA
Detailed Description
Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.
Background
1. The hospital environment is conducive for the rapid spread of pathogens, especially antimicrobial-resistant bacteria. Hospital-acquired methicillin-resistant staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) infections are increasing worldwide, including Singapore.
2. Good hand hygiene is the single most important measure to prevent the nosocomial spread of pathogens in healthcare settings. However, most studies have reported compliance rates of \<50%, under routine hospital practice. The last hand hygiene audit in TTSH revealed a compliance rate of merely 20%. Recent studies have observed that this level of compliance would not reduce the transmission risk of multi-resistant bacteria in the hospital. A high workload and insufficient time for hand hygiene are common reasons cited by healthcare workers for poor compliance with hand hygiene.
3. Hospital staff are responsible for 20-40% of nosocomial spread of pathogens from patient to patient through contact transmission. Bacterial contamination of healthcare workers' hands during routine patient care has been reported to increase linearly with time, with an average increase of 16 colony-forming units (CFUs) per minute of patient care.
4. The use of alcohol handrubs has been demonstrated to significantly reduce time spent on hand hygiene (40-80 seconds required for hand-washing vs 20 seconds for alcohol hand-rubbing). Although there is growing evidence from experimental studies that alcohol-based products are more effective than soap or antimicrobial soaps, there have been very few trials done in the clinical setting evaluating the two hand hygiene protocols in everyday practice.
5. A randomised controlled trial carried out in 3 intensive care units (ICUs) of a 940-bedded French tertiary care and referral university hospital demonstrated the superior antimicrobial efficacy of alcohol hand-rubbing compared with chlorhexidine hand-washing. The median percentage reduction in bacterial contamination was significantly higher with alcohol hand-rubbing than with hand-washing (83% vs 58%, p = 0.012). Another randomised clinical trial involving 4 general wards and 3 ICUs at the 850-bedded University of Barcelona Hospital demonstrated similar findings. It reported an average reduction in hand bacterial load of 88.2% with alcoholic hand-wash, compared with 49.6% with regular liquid soap.
6. Since the introduction of alcohol handrubs at Tan Tock Seng Hospital (TTSH), the hospital has adopted the hand hygiene guidelines issued by the Centers for Disease Control and Prevention (CDC). The CDC guidelines do not specifically discuss the technique for using alcohol-based handrubs. However, the recent World Health Organization (WHO)'s Guidelines on Hand Hygiene in Health Care (Advanced Draft) April 2006 have detailed the hand hygiene technique with alcohol-based formulation. WHO's recommended alcohol hand-rubbing technique involves the same standard 7-steps adopted in hand-washing with antiseptic soap and water.
7. Busy healthcare staff are often unable to adhere to the 7-step hand hygiene technique. Hence, the most convenient hand hygiene protocol would be hand-rubbing with alcohol, covering all hand surfaces until dry, as recommended by the CDC. This is the protocol currently adopted by TTSH. However, there has been growing concern that there could be missed areas on the hands after alcohol hand-rubbing, which might affect the efficacy of the alcohol handrub \[20, 21\].
8. There have been very few published clinical studies comparing the efficacy of alcohol hand-rubbing with antiseptic hand-washing in healthcare workers during routine patient care. To our knowledge, there has not been a published international study comparing CDC's recommended alcohol hand-rubbing protocol with that of the WHO's. This study will provide important information on the efficacy of alcohol hand-rubbing using the current technique adopted in TTSH (CDC's guidelines), compared with the WHO's recommended 7-step technique for alcohol hand-rubbing and the standard 7-step chlorhexidine hand-washing respectively. This study will also provide local data on the actual time spent on hand hygiene, during everyday practice. The findings from this study will contribute significantly towards understanding hand hygiene practices during routine patient care in our local healthcare setting and hence guide infection control strategies to reduce hospital-acquired infections. Reducing hospital-acquired infections would lead to improved clinical outcomes for our patients.
Study Hypothesis:
9. Alcohol hand-rubbing covering all hand surfaces is not less effective in reducing bacterial hand contamination of healthcare staff than alcohol hand-rubbing using 7-step technique; and is more effective than chlohexidine handwashing. Time spent on alcohol hand-rubbing covering all hand surfaces is less than that required by the other 2 hand hygiene protocols respectively.
Objectives
10. The primary objective of this study is to evaluate the efficacy of 3 hand hygiene protocols: hand-rubbing with alcohol covering all hand surfaces, hand-rubbing with alcohol using the standard 7-step technique, and hand-washing with chlorhexidine using the standard 7-step technique. The secondary objectives include the estimation of time spent on hand hygiene, for each hand hygiene protocol; and the evaluation of bacterial hand contamination after key patient care activities.
Methods
11. This study will be a prospective randomised controlled trial, with blinded evaluation of microbiological results. Three hand hygiene protocols will be compared: hand-rubbing with alcohol covering all hand surfaces, hand-rubbing with alcohol using the standard 7-step technique, and hand-washing with chlorhexidine using the standard 7-step technique.
12. Medical and nursing staff from general wards in TTSH will be invited to participate in the study. 60 medical staff (namely medical officers and house officers) and 60 nursing staff (namely registered nurses and enrolled nurses) will be recruited for the study. The medical and nursing teams working in the selected wards will be informed of the study prior to its commencement, and the support of the respective unit and department heads sought. An information sheet describing the study will be circulated prior to the study.
13. The study will be carried out over 8 weeks, during the day shifts, from Monday to Friday. Two infection control nurses and a research associate will work as a team, moving systematically from one ward to the next. On the day of the study, the team will observe the patient care activities in the participating ward, and look out for activities involving direct patient contact (such as physical examination, temperature or blood pressure taking), without the use of gloves.
14. Whenever a medical or nursing staff is about to perform an activity involving direct patient contact without the use of gloves, the staff will be approached and invited to participate in the study. Verbal consent will be taken from staff who accept the invitation to participate. To protect the identity and confidentiality of the participating staff, written consent will not be taken.
15. Three samples for bacterial counts will be taken from the dominant hand of each participant: just prior to patient contact, after patient contact, and after hand hygiene.
16. Each participant will be randomly assigned to one of the 3 hand hygiene protocols:
* hand-rubbing with alcohol covering all hand surfaces,
* hand-rubbing with alcohol using the standard 7-step technique, or
* hand-washing with chlorhexidine using the standard 7-step technique. Pre-prepared sealed envelopes will be used. Participants allocated into hand hygiene protocols (1) and (3) will be asked to perform the hand hygiene method, as they normally would. Participants assigned to hand hygiene protocol (2) will be requested to perform hand-rubbing with alcohol, using the technique they would normally adopt for chlorhexidine hand-washing.
17. The two infection control nurses will separately monitor the time taken by each participant for the patient care activity using a stopwatch, and record the duration and type of patient care performed in the data collection form. The data collection form will only contain a study number and will not bear the name or identification of the participant. A study number will be randomly assigned to each participant using pre-numbered data collection forms. Similarly, the infection control nurses will observe and record the duration of each hand hygiene and note adherence to the allocated hand hygiene technique. The infection control nurses will only make observations, and will not interfere with hand hygiene whatever the method used. (Pls see attached data collection form)
18. Participants assigned to one of the 2 alcohol hand-rubbing protocols but whose hands become visibly soiled after patient care, will be advised to perform chlorhexidine hand-washing instead.
19. The research associate, who has undergone training in the sampling technique, will be responsible for taking hand samples for bacterial counts, using the glove juice technique. Samples will be labelled with study numbers only. Innoculated agar plates will be incubated at 37 degC under aerobic conditions. The total bacterial contamination of hands in terms of the number of colony forming units (cfu) will be recorded after 48 hours of incubation. Bacteria present in the samples will also be qualitatively identified and reported. The microbiologist examining the culture plates and reporting the microbiological results will be blinded to the hand hygiene method used.
20. Each staff will only be approached once. The time taken for each sample collection will be less than a minute. The study team will ensure that the study will not interfere with routine patient care activities.
21. Strict confidentiality of participants will be maintained. All data collected, including microbiological results, will be identified only by the study number and cannot be traced to the participating staff.
1. The hospital environment is conducive for the rapid spread of pathogens, especially antimicrobial-resistant bacteria. Hospital-acquired methicillin-resistant staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) infections are increasing worldwide, including Singapore.
2. Good hand hygiene is the single most important measure to prevent the nosocomial spread of pathogens in healthcare settings. However, most studies have reported compliance rates of \<50%, under routine hospital practice. The last hand hygiene audit in TTSH revealed a compliance rate of merely 20%. Recent studies have observed that this level of compliance would not reduce the transmission risk of multi-resistant bacteria in the hospital. A high workload and insufficient time for hand hygiene are common reasons cited by healthcare workers for poor compliance with hand hygiene.
3. Hospital staff are responsible for 20-40% of nosocomial spread of pathogens from patient to patient through contact transmission. Bacterial contamination of healthcare workers' hands during routine patient care has been reported to increase linearly with time, with an average increase of 16 colony-forming units (CFUs) per minute of patient care.
4. The use of alcohol handrubs has been demonstrated to significantly reduce time spent on hand hygiene (40-80 seconds required for hand-washing vs 20 seconds for alcohol hand-rubbing). Although there is growing evidence from experimental studies that alcohol-based products are more effective than soap or antimicrobial soaps, there have been very few trials done in the clinical setting evaluating the two hand hygiene protocols in everyday practice.
5. A randomised controlled trial carried out in 3 intensive care units (ICUs) of a 940-bedded French tertiary care and referral university hospital demonstrated the superior antimicrobial efficacy of alcohol hand-rubbing compared with chlorhexidine hand-washing. The median percentage reduction in bacterial contamination was significantly higher with alcohol hand-rubbing than with hand-washing (83% vs 58%, p = 0.012). Another randomised clinical trial involving 4 general wards and 3 ICUs at the 850-bedded University of Barcelona Hospital demonstrated similar findings. It reported an average reduction in hand bacterial load of 88.2% with alcoholic hand-wash, compared with 49.6% with regular liquid soap.
6. Since the introduction of alcohol handrubs at Tan Tock Seng Hospital (TTSH), the hospital has adopted the hand hygiene guidelines issued by the Centers for Disease Control and Prevention (CDC). The CDC guidelines do not specifically discuss the technique for using alcohol-based handrubs. However, the recent World Health Organization (WHO)'s Guidelines on Hand Hygiene in Health Care (Advanced Draft) April 2006 have detailed the hand hygiene technique with alcohol-based formulation. WHO's recommended alcohol hand-rubbing technique involves the same standard 7-steps adopted in hand-washing with antiseptic soap and water.
7. Busy healthcare staff are often unable to adhere to the 7-step hand hygiene technique. Hence, the most convenient hand hygiene protocol would be hand-rubbing with alcohol, covering all hand surfaces until dry, as recommended by the CDC. This is the protocol currently adopted by TTSH. However, there has been growing concern that there could be missed areas on the hands after alcohol hand-rubbing, which might affect the efficacy of the alcohol handrub \[20, 21\].
8. There have been very few published clinical studies comparing the efficacy of alcohol hand-rubbing with antiseptic hand-washing in healthcare workers during routine patient care. To our knowledge, there has not been a published international study comparing CDC's recommended alcohol hand-rubbing protocol with that of the WHO's. This study will provide important information on the efficacy of alcohol hand-rubbing using the current technique adopted in TTSH (CDC's guidelines), compared with the WHO's recommended 7-step technique for alcohol hand-rubbing and the standard 7-step chlorhexidine hand-washing respectively. This study will also provide local data on the actual time spent on hand hygiene, during everyday practice. The findings from this study will contribute significantly towards understanding hand hygiene practices during routine patient care in our local healthcare setting and hence guide infection control strategies to reduce hospital-acquired infections. Reducing hospital-acquired infections would lead to improved clinical outcomes for our patients.
Study Hypothesis:
9. Alcohol hand-rubbing covering all hand surfaces is not less effective in reducing bacterial hand contamination of healthcare staff than alcohol hand-rubbing using 7-step technique; and is more effective than chlohexidine handwashing. Time spent on alcohol hand-rubbing covering all hand surfaces is less than that required by the other 2 hand hygiene protocols respectively.
Objectives
10. The primary objective of this study is to evaluate the efficacy of 3 hand hygiene protocols: hand-rubbing with alcohol covering all hand surfaces, hand-rubbing with alcohol using the standard 7-step technique, and hand-washing with chlorhexidine using the standard 7-step technique. The secondary objectives include the estimation of time spent on hand hygiene, for each hand hygiene protocol; and the evaluation of bacterial hand contamination after key patient care activities.
Methods
11. This study will be a prospective randomised controlled trial, with blinded evaluation of microbiological results. Three hand hygiene protocols will be compared: hand-rubbing with alcohol covering all hand surfaces, hand-rubbing with alcohol using the standard 7-step technique, and hand-washing with chlorhexidine using the standard 7-step technique.
12. Medical and nursing staff from general wards in TTSH will be invited to participate in the study. 60 medical staff (namely medical officers and house officers) and 60 nursing staff (namely registered nurses and enrolled nurses) will be recruited for the study. The medical and nursing teams working in the selected wards will be informed of the study prior to its commencement, and the support of the respective unit and department heads sought. An information sheet describing the study will be circulated prior to the study.
13. The study will be carried out over 8 weeks, during the day shifts, from Monday to Friday. Two infection control nurses and a research associate will work as a team, moving systematically from one ward to the next. On the day of the study, the team will observe the patient care activities in the participating ward, and look out for activities involving direct patient contact (such as physical examination, temperature or blood pressure taking), without the use of gloves.
14. Whenever a medical or nursing staff is about to perform an activity involving direct patient contact without the use of gloves, the staff will be approached and invited to participate in the study. Verbal consent will be taken from staff who accept the invitation to participate. To protect the identity and confidentiality of the participating staff, written consent will not be taken.
15. Three samples for bacterial counts will be taken from the dominant hand of each participant: just prior to patient contact, after patient contact, and after hand hygiene.
16. Each participant will be randomly assigned to one of the 3 hand hygiene protocols:
* hand-rubbing with alcohol covering all hand surfaces,
* hand-rubbing with alcohol using the standard 7-step technique, or
* hand-washing with chlorhexidine using the standard 7-step technique. Pre-prepared sealed envelopes will be used. Participants allocated into hand hygiene protocols (1) and (3) will be asked to perform the hand hygiene method, as they normally would. Participants assigned to hand hygiene protocol (2) will be requested to perform hand-rubbing with alcohol, using the technique they would normally adopt for chlorhexidine hand-washing.
17. The two infection control nurses will separately monitor the time taken by each participant for the patient care activity using a stopwatch, and record the duration and type of patient care performed in the data collection form. The data collection form will only contain a study number and will not bear the name or identification of the participant. A study number will be randomly assigned to each participant using pre-numbered data collection forms. Similarly, the infection control nurses will observe and record the duration of each hand hygiene and note adherence to the allocated hand hygiene technique. The infection control nurses will only make observations, and will not interfere with hand hygiene whatever the method used. (Pls see attached data collection form)
18. Participants assigned to one of the 2 alcohol hand-rubbing protocols but whose hands become visibly soiled after patient care, will be advised to perform chlorhexidine hand-washing instead.
19. The research associate, who has undergone training in the sampling technique, will be responsible for taking hand samples for bacterial counts, using the glove juice technique. Samples will be labelled with study numbers only. Innoculated agar plates will be incubated at 37 degC under aerobic conditions. The total bacterial contamination of hands in terms of the number of colony forming units (cfu) will be recorded after 48 hours of incubation. Bacteria present in the samples will also be qualitatively identified and reported. The microbiologist examining the culture plates and reporting the microbiological results will be blinded to the hand hygiene method used.
20. Each staff will only be approached once. The time taken for each sample collection will be less than a minute. The study team will ensure that the study will not interfere with routine patient care activities.
21. Strict confidentiality of participants will be maintained. All data collected, including microbiological results, will be identified only by the study number and cannot be traced to the participating staff.
Conditions
See the medical conditions and disease areas that this research is targeting or investigating.
Efficacy of Hand Hygiene Protocols
Study Design
Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.
Allocation Method
RANDOMIZED
Intervention Model
PARALLEL
Primary Study Purpose
HEALTH_SERVICES_RESEARCH
Blinding Strategy
SINGLE
Outcome Assessors
Study Groups
Review each arm or cohort in the study, along with the interventions and objectives associated with them.
WHO alcohol handrub protocol
handrubbing with alcohol using the standard 7-step technique (WHO alcohol handrub protocol)
Group Type
OTHER
Hand hygiene protocol
Intervention Type
OTHER
Comparison of efficacy of 3 hand hygiene protocols
CDC alcohol handrub protocol
Handrubbing with alcohol covering all hand surfaces in no particular order (CDC alcohol handrub protocol)
Group Type
OTHER
Hand hygiene protocol
Intervention Type
OTHER
Comparison of efficacy of 3 hand hygiene protocols
Chlorhexidine handwashing
chlorhexidine handwashing using the standard 7-step technique (WHO handwashing protocol)
Group Type
OTHER
Hand hygiene protocol
Intervention Type
OTHER
Comparison of efficacy of 3 hand hygiene protocols
Interventions
Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.
Hand hygiene protocol
Comparison of efficacy of 3 hand hygiene protocols
Intervention Type
OTHER
Other Intervention Names
Discover alternative or legacy names that may be used to describe the listed interventions across different sources.
time-effectiveness
efficacy
hand hygiene
alcohol handrub
Eligibility Criteria
Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.
Inclusion Criteria
medical and nursing staff working in general wards in Tan Tock Seng Hospital
Eligible Sex
ALL
Accepts Healthy Volunteers
Yes
Sponsors
Meet the organizations funding or collaborating on the study and learn about their roles.
Tan Tock Seng Hospital
OTHER
Sponsor Role
lead
Responsible Party
Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.
Tan Tock Seng Hospital
Principal Investigators
Learn about the lead researchers overseeing the trial and their institutional affiliations.
Angela LP Chow, MBBS, MPH
Role: PRINCIPAL_INVESTIGATOR
Tan Tock Seng Hospital
Locations
Explore where the study is taking place and check the recruitment status at each participating site.
Tan Tock Seng Hospital
Singapore, Singapore, Singapore
Site Status
Countries
Review the countries where the study has at least one active or historical site.
Singapore
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
SIG08012
Identifier Type: OTHER_GRANT
Identifier Source: secondary_id
NHG DSRB B/07/310
Identifier Type: -
Identifier Source: org_study_id
More Related Trials
Additional clinical trials that may be relevant based on similarity analysis.
Simplifying the World Health Organization (WHO) Protocol for Hand Hygiene
NCT03588221
COMPLETED
NA
Effectiveness of a Multimodal IT Enhanced Hand Hygiene Strategy on Healthcare Associated Infections in Nursing Homes
NCT06925620
COMPLETED
NA
A Multifaceted Intervention to Improve Hand Hygiene
NCT00375037
COMPLETED
NA
Implementation of Directly Observed Hand Hygiene in Residential Care Home for the Elderly: a Cluster Randomized Trial
NCT03224169
UNKNOWN
NA
The Antiseptic Outcome of Traditional Hand Scrubbing Versus Hand Rubbing in Surgical Room
NCT02294604
COMPLETED
NA
Effectiveness of Chlorhexidine Wipe for Prevention of Multidrug-resistant Organisms in Intensive Care Unit Patients
NCT01989416
COMPLETED
PHASE3
A Two-week Crossover Evaluation of Two Hand Antiseptic Products on Skin Condition in Healthy Human Subjects
NCT00731042
COMPLETED
PHASE4
Microbial and Pharmacological Assessment of Chlorhexidine
NCT03290105
COMPLETED
Chlorhexidine Against Sodium Hypochlorite as Skin Antiseptics
NCT01321125
COMPLETED
PHASE3
Antiseptic Scrub Contamination and Transmission Trial
NCT02645214
COMPLETED
NA
Pilot Study to Determine the Effectiveness of Antimicrobial Healthcare Worker's (HCW) Hands and Clothing
NCT00971373
COMPLETED
NA
How COVID-19 Virus Outbreak Affects Antimicrobial Resistance in a Low-middle-income Country's ICU?
NCT04348227
UNKNOWN
The Impact of Patient Motivational Dialogue (PMD) on Patient Self-advocacy for Hand Hygiene
NCT04360057
COMPLETED
NA
Efficacy Study Comparing 2% Chlorhexidine in 70% Isopropyl Alcohol Versus 2% Aqueous Chlorhexidine
NCT01270776
UNKNOWN
NA
Building an Optimal Hand Hygiene Bundle
NCT02223455
COMPLETED
NA
Perioperative Patient Skin Antiseptic Preparation Evaluation
NCT04756804
COMPLETED
PHASE3
Bacterial Contamination of Healthcare Worker Uniforms
NCT01537835
COMPLETED
NA
Study of the Efficacy of Plain Soap and Water Versus Alcohol-based Rubs for Surgical Hand Preparation
NCT00987402
COMPLETED
PHASE1/PHASE2
Skin Cleansing With Chlorhexidine to Decrease Hospital Acquired Infections
NCT00130221
COMPLETED
PHASE1
Impact of Enhanced Daily Disinfection on Environmental Contamination in Hospital Rooms
NCT05739955
RECRUITING
NA
• Comparison of Blood Culture Contamination Rates
NCT05576233
UNKNOWN
NA
Alcohol Versus Chlorhexidine With and Without Water
NCT02640469
WITHDRAWN
NA
A Blended Gaming COVID-19 Training System (BGCTS) With WHO Guidelines for Staff in Residential Care Homes
NCT04783025
UNKNOWN
NA
Effectiveness of Nurse-Led Education Programmes to Enhance Infection Prevention and Control Among Childcare Workers in Bangkok Daycare Centres, Thailand
NCT06736977
RECRUITING
NA
Residual Effect of Chlorhexidine-alcohol Compared to Triclosan-alcohol
NCT01762904
COMPLETED
PHASE3