UMIN-CTR Clinical Trial

Unique ID issued by UMIN UMIN000062729
Receipt number R000071826
Scientific Title Sustained Antimicrobial Efficacy of Silver-Ion/Hydrogen Peroxide versus Quaternary Ammonium on High-Touch Operating Room Surfaces: A Multicenter Randomized Controlled Trial
Date of disclosure of the study information 2026/08/28
Last modified on 2026/08/28 21:09:06

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Basic information

Public title

Sustained Antimicrobial Efficacy of Silver-Ion/Hydrogen Peroxide versus Quaternary Ammonium on High-Touch Operating Room Surfaces: A Multicenter Randomized Controlled Trial

Acronym

HP-Ag vs QAC OR Trial

Scientific Title

Sustained Antimicrobial Efficacy of Silver-Ion/Hydrogen Peroxide versus Quaternary Ammonium on High-Touch Operating Room Surfaces: A Multicenter Randomized Controlled Trial

Scientific Title:Acronym

HP-Ag vs QAC OR Trial

Region

Asia(except Japan)


Condition

Condition

Microbial contamination of high-touch operating room surfaces

Classification by specialty

Operative medicine

Classification by malignancy

Others

Genomic information

NO


Objectives

Narrative objectives1

To compare the immediate and sustained antimicrobial efficacy of hydrogen peroxide stabilized with silver ions (HP-Ag) versus quaternary ammonium compounds (QACs) on high-touch operating room surfaces, and secondarily to explore their association with 30-day postoperative surgical site infection rates.

Basic objectives2

Efficacy

Basic objectives -Others


Trial characteristics_1

Confirmatory

Trial characteristics_2

Explanatory

Developmental phase

Not applicable


Assessment

Primary outcomes

Surface recontamination rate at 4 hours after disinfection (T3), defined as any detectable bacterial growth (>0 CFU/mL) on predefined high-touch operating room surfaces following complete microbial elimination immediately after disinfection (T1).

Key secondary outcomes

1. Microbial burden on predefined high-touch operating room surfaces, measured as CFU/mL immediately after disinfection (T1), 2 hours after disinfection (T2), and 4 hours after disinfection (T3).
2. Surface recontamination rate at 2 hours after disinfection (T2), defined as any detectable bacterial growth (>0 CFU/mL).
3. Incidence of postoperative surgical site infection within 30 days after surgery, assessed according to CDC criteria.


Base

Study type

Interventional


Study design

Basic design

Parallel

Randomization

Randomized

Randomization unit

Cluster

Blinding

Open -but assessor(s) are blinded

Control

Active

Stratification

NO

Dynamic allocation

NO

Institution consideration


Blocking

YES

Concealment

Numbered container method


Intervention

No. of arms

2

Purpose of intervention

Prevention

Type of intervention

Other

Interventions/Control_1

Hydrogen peroxide stabilized with silver ions (HP-Ag): High-touch operating room surfaces were pre-cleaned using disposable detergent-impregnated wipes and then disinfected with a ready-to-use 2% hydrogen peroxide solution stabilized with 10 ppm silver ions. The disinfectant was applied using sterile microfiber towels in a standardized S-shaped wiping pattern with a minimum wet contact time of 1 minute. One disinfection session was performed for each randomized operating room, followed by environmental monitoring for 4 hours.

Interventions/Control_2

Quaternary ammonium compound (QAC): High-touch operating room surfaces were pre-cleaned using disposable detergent-impregnated wipes and then disinfected with a hospital-grade quaternary ammonium compound containing alkyl dimethyl benzyl ammonium chloride (ADBAC) and didecyl dimethyl ammonium chloride (DDAC) at an in-use concentration of 400 ppm. The disinfectant was applied using sterile microfiber towels in a standardized S-shaped wiping pattern with a minimum wet contact time of 1 minute. One disinfection session was performed for each randomized operating room, followed by environmental monitoring for 4 hours.

Interventions/Control_3


Interventions/Control_4


Interventions/Control_5


Interventions/Control_6


Interventions/Control_7


Interventions/Control_8


Interventions/Control_9


Interventions/Control_10



Eligibility

Age-lower limit

18 years-old <=

Age-upper limit


Not applicable

Gender

Male and Female

Key inclusion criteria

1. Adult patients aged 18 years or older.
2. Undergoing elective, clean surgical procedures in randomized operating rooms.
3. Eligible procedures: laparoscopic cholecystectomy, mesh inguinal hernia repair, umbilical hernia repair, small ventral hernia repair, non-perforated laparoscopic appendectomy, or thyroidectomy.
4. ASA physical status I or II.
5. Operative duration strictly between 60 and 120 minutes.
6. Receipt of standardized antimicrobial prophylaxis and standardized skin antisepsis.

Key exclusion criteria

1. Contaminated surgical wound.
2. Emergency surgery.
3. Active systemic or localized infection.
4. Immunocompromised status.
5. Uncontrolled diabetes mellitus.
6. Pregnancy.
7. Previous surgical intervention in the same anatomical region.

Target sample size

400


Research contact person

Name of lead principal investigator

1st name Seyed Abolfazl
Middle name
Last name Hosseini

Organization

Golestan University of Medical Sciences

Division name

Department of Surgical Technology, Faculty of Paramedical Sciences

Zip code

4918936316

Address

Faculty of Paramedical Sciences, Golestan University of Medical Sciences, Gorgan-Sari Road, Gorgan, Golestan Province, Iran

TEL

+981732430310

Email

hosseinia1377@gmail.com


Public contact

Name of contact person

1st name Seyed Abolfazl
Middle name
Last name Hosseini

Organization

Golestan University of Medical Sciences

Division name

Department of Surgical Technology, Faculty of Paramedical Sciences

Zip code

4918936316

Address

Faculty of Paramedical Sciences, Golestan University of Medical Sciences, Gorgan-Sari Road, Gorgan,

TEL

+981732430310

Homepage URL

https://goums.ac.ir/

Email

hosseinia1377@gmail.com


Sponsor or person

Institute

Birjand University of Medical Sciences

Institute

Department

Personal name



Funding Source

Organization

Self-funded by the investigators

Organization

Division

Category of Funding Organization

Self funding

Nationality of Funding Organization



Other related organizations

Co-sponsor


Name of secondary funder(s)



IRB Contact (For public release)

Organization

Research Ethics Committee, Birjand University of Medical Sciences

Address

Birjand University of Medical Sciences, Ghaffari Street, Birjand, South Khorasan, Iran

Tel

+985632395000

Email

public-r@bums.ac.ir


Secondary IDs

Secondary IDs

NO

Study ID_1


Org. issuing International ID_1


Study ID_2


Org. issuing International ID_2


IND to MHLW



Institutions

Institutions

Four teaching hospitals affiliated with Birjand University of Medical Sciences (Birjand, South Khorasan, Iran)


Other administrative information

Date of disclosure of the study information

2026 Year 08 Month 28 Day


Related information

URL releasing protocol


Publication of results

Unpublished


Result

URL related to results and publications


Number of participants that the trial has enrolled

400

Results

Fifty operating rooms and 400 patients were analyzed. Both disinfectants achieved complete immediate microbial elimination. At 4 hours, median microbial burden was 0 CFU/mL with HP-Ag versus 20 CFU/mL with QAC (P<0.001). Surface recontamination was 29.3% versus 100% (P<0.001). Thirty-day SSI occurred in 2/200 patients (1.0%) with HP-Ag and 9/200 (4.5%) with QAC (P=0.062).

Results date posted

2026 Year 08 Month 28 Day

Results Delayed


Results Delay Reason


Date of the first journal publication of results


Baseline Characteristics

Baseline characteristics were comparable between groups. Mean age was 47.8 +/- 13.2 years in the HP-Ag group and 48.9 +/- 12.6 years in the QAC group. Sex, ASA status, operative time, procedure type, OR temperature, relative humidity, air changes per hour, and baseline microbial burden showed no significant between-group differences.

Participant flow

A total of 50 operating rooms were randomized in a 1:1 ratio to HP-Ag (25 operating rooms) or QAC (25 operating rooms). Each group included 150 predefined high-touch surfaces and 200 surgical patients. All 50 operating rooms and all 400 enrolled patients completed the study, with no post-randomization loss or exclusion.

Adverse events

No intervention-related adverse events were reported. The interventions consisted of environmental surface disinfection and were not directly administered to patients.

Outcome measures

Primary outcome: Surface recontamination rate at 4 hours after disinfection. Recontamination occurred in 44/150 surfaces (29.3%) in the HP-Ag group and 150/150 surfaces (100%) in the QAC group (P<0.001).
Secondary environmental outcomes: Median microbial burden at 2 hours was 0.0 CFU/mL in the HP-Ag group and 5.0 CFU/mL in the QAC group (P<0.001); at 4 hours it was 0.0 and 20.0 CFU/mL, respectively (P<0.001). Recontamination at 2 hours occurred in 10.7% versus 77.3%, respectively (P<0.001).
Secondary clinical outcome: Thirty-day surgical site infection occurred in 1.0% of patients in the HP-Ag group and 4.5% in the QAC group (P=0.062).

Plan to share IPD

No

IPD sharing Plan description

Individual participant data are not planned for public sharing. De-identified data may be considered upon reasonable request to the corresponding author, subject to institutional and ethical approval.


Progress

Recruitment status

Completed

Date of protocol fixation

2024 Year 12 Month 15 Day

Date of IRB

2024 Year 12 Month 30 Day

Anticipated trial start date

2025 Year 01 Month 01 Day

Last follow-up date

2025 Year 08 Month 31 Day

Date of closure to data entry


Date trial data considered complete


Date analysis concluded



Other

Other related information

This study was retrospectively registered after completion of the trial during the journal peer-review process.


Management information

Registered date

2026 Year 08 Month 28 Day

Last modified on

2026 Year 08 Month 28 Day



Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000071826