Participants and sample collection

The study was approved by the ethics committee of the University Faculty of Medicine, Ankara (registration number 2019/02/06). A total of 45 adult volunteers who were not healthcare workers were included in this study. The sample size was calculated as 16 with a 95% confidence interval and 80% power using the OpenEpi (https: //www.openepi.com/SampleSize/SSPropor.Htm) programme [8]. We included 40% more than the calculated value. Exclusion criteria included existing skin disorders or lacerations, pregnancy, presence of nail polish, recent hand washing or use of antiseptic lotion/soap use in the last week, and antibiotic use in the last 3 months. Gender, age and the dominant hand were recorded. Informed consent was obtained from all participants.

At baseline, each subject was asked to rub the fingertips of the dominant hand on sheep-blood agar plate. Following sample collection, the subjects were asked to rub their hands according to the World Health Organization’s (WHO) “How to Hand Rub” technique [9]. The subjects were randomly divided into two groups: one group rubbed their hand with 3 mL of alcohol-based hand antiseptic and the other group with 3 mL of rose hydrosol. After the hand-rubbing sequence, the hands were allowed to air-dry and fingertip sampling was performed again.

The commercially available product (MANOCHOL™ EP-70) used as the alcohol-based hand rub contained 70% ethanol. The Rosa damascena hydrosol used was a commercial product produced according to the national standard of the Turkish Standards Institution (TSE, “Rose Water Monograph” TS 5555, 1988).