Gel Fingernail Polish & Viable Bacteria Counts in Small Animal Surgery
Lisa Corti, DVM, DACVS, CCRP, North Shore Veterinary Surgery, Andover, Massachusetts, North Shore Community College, Danvers, Massachusetts
In the Literature
Anderson SL, Wisnieski L, Achilles SL, Wooton KE, Schaffer CL, Hunt JA. The impact of gel fingernail polish application on the reduction of bacterial viability following a surgical hand scrub. Vet Surg. 2021;50(7):1525-1532. doi:10.1111/vsu.13703
The Research ...
Because sterile gloves are commonly punctured during surgical procedures, hand disinfection is essential to lower the rate of surgical site infections1-4; however, the area underneath the fingernails harbors bacteria and can be difficult to clean.4,5 Nail polish has traditionally been thought to harbor microbes and increase the risk for transferring bacteria to patients.6,7 Studies in both human and veterinary medicine have evaluated whether nail polish influences the bacterial load on fingernails, with variable results.4,5,7-10
This randomized controlled trial evaluated the effect of gel nail polish on the number of viable bacteria present before and after a surgical hand scrub 1 day and 14 days after a manicure from a licensed cosmetologist. A total of 40 veterinary students and faculty participated and washed their hands and fingernails with chlorhexidine gluconate 4% as part of the manicure. Nails from both hands were trimmed and filed to <2 mm in length and randomly assigned to receive or not receive gel polish.
On days 1 and 14, fingernails were sampled for culture with sterile toothpicks and phosphate-buffered, saline-soaked cotton swabs before and after a standard 5-minute presurgical hand scrub consisting of a chlorhexidine gluconate 4% sterile brush and sponge with a plastic pick to clean under the fingernails. Culture samples were taken from the cuticle, nail plate, and underside of each nail and placed on agar plates. The number of colony-forming units per mL (ie, viable bacteria) were counted.
No significant difference in the number of viable bacteria detected from nails with or without gel polish after the standard surgical scrub was found; however, longer fingernail length was significantly correlated with a higher number of postscrub viable bacteria.
... The Takeaways
Key pearls to put into practice:
Applying gel or acrylic nail polish does not increase risk for presence of viable bacteria after a surgical hand scrub.5,7,9,10
Fingernail length is a risk factor for postscrub viable bacteria. Nail length <2 mm is recommended when scrubbing into surgical procedures.4,5,8,10
Because sterile gloves are commonly punctured during surgery,1-3 presurgical hand cleaning heavily impacts development of surgical site infections.4,7,11,12 One standard surgical preparation uses a sterile chlorhexidine gluconate 4% sponge and brush with a fingernail pick.5,11,12 The pick is used to remove debris from under the fingernails, then the brush is used to scrub the nails. A 5-minute scrub with the sponge is performed, cleaning each side of the fingers, hands, and forearms up to the elbows.5,11 Alcohol-based hand rubs are popular in human and veterinary medicine and may be superior to chlorhexidine and povidone-iodine scrubs when manufacturer recommendations are followed.4,7,11,12
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