urrent recommendations to discontinue routine pre-injection skin preparation may jeopardise patient safety and increase the risk of infection. However, the best available evidence and theoretical rationale may offer sufficient support for recommendations to abandon this practice. Both sides of this argument are explored in this `point-counterpoint' review.
Anon. (1985) Nursing Times (Journal of Infection Control Nursing) 81(35): suppl.14.
2.
Ayliffe Gaj, Coates D., Hoffman PN (1993). Chemical disinfection in hospitals (second edition). Public Health Laboratory Service: London: 72.
3.
Dann TC ( 1969). Routine skin preparation before injection: an unnecessary procedure. Lancet2(7611): 96-8.
4.
Elek SD, Conen PE (1957). The virulence of Staphylococcus aureus for man: a study of the problems of wound infection. BritishJournal of Experimental Pathology38(6): 573-86.
5.
Hoffman PN (2001). Skin disinfection and acupuncture. Acupuncture in Medicine19(2):112-6. See: www.medical-acupuncture.co.uk/journal/2001(2)/2001_2.pdf (accessed 5 June 2005).
6.
Hutin Y., Jauri A., Chiarello L., Catlin M., Stilwell B., Ghebrehiwet T., Garner J., members of the injection safety best practices development group. (2003). Best infection control practices for intradermal, subcutaneous, and intramuscular needle injections. Bulletin of the World Health Organization81(7): 491-500. See: www.who.int/bulletin/en/ (accessed 5 June 2005).
7.
Kovisto VA, Felig P. (1978). Is skin preparation necessary before insulin injection?Lancet1(8073): 1072-3.
Sweetman S. (1999) Martindale: The complete drug reference (32nd edition). The Pharmaceutical Press : London.
10.
National Audit Office. (2004) Improving patient care by reducing the risk of hospital acquired infection: a progress report. Report by the Comptroller and Auditor General. HC 876 Session 2003-2004. The Stationery Office: London: 68. See: www.nao.org.uk/publications/nao_reports/03-04/0304876.pdf (accessed 5 June 2005).
11.
Noble WC (1981). Microbiology of human skin (second edition). Lloyd-Luke: London.
12.
Pratt RJ, Morgan S., Hughes J., Mulhall A., Fry C., Perry C., Tew L. ( 2002). Healthcare governance and the modernisation of the NHS: infection prevention and control. British Journal of Infection Control3(5):16-25. See: www.richardwellsresearch.com (accessed 5 June 2005).
13.
Royal Colleges of Paediatrics and Child Health, Nursing, General Practitioners and the Community Practitioners' and Health Visitors' Association. (2002). Position statement on injection technique . Royal College of Paediatrics and Child Health: London: 4. See: www.rcn.org.uk/publications/pdf/injection-technique.pdf (accessed 5 June 2005).
14.
Selwyn S., Ellis H. (1972). Skin bacteria and skin disinfection reconsidered . British Medical Journal1(793): 136-40.
15.
Sutton CD, White SA, Edwards R., Lewis MH (1999). A prospective controlled trial of the efficacy of isopropyl alcohol wipes before venesection in surgical patients. Annals of the Royal College of Surgeons England81(3): 183-6.
16.
Turner Rwd. (1969). Skins and needles. Lancet2(7618): 490-1.
17.
World Health Organization. (1995). Guide to good prescribing: a practical manual. Annex 4: The use of injections . World Health Organization: Geneva . See: www.med.uva.es/who/index.html (accessed 5 June 2005).
