Hand sanitizer

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The articles disinfection , hand disinfection , hand disinfectant , sterilization , antiseptic , antisepsis , preservation and preservatives overlap thematically. Help me to better differentiate or merge the articles (→  instructions ) . To do this, take part in the relevant redundancy discussion . Please remove this module only after the redundancy has been completely processed and do not forget to include the relevant entry on the redundancy discussion page{{ Done | 1 = ~~~~}}to mark. TheGlobetrotter Comments old font awesome.svg  ~ 02:47, 28 Apr 2020 (CEST) 02:47, 28 Apr 2020 (CEST)
Wall dispenser for alcoholic hand disinfectant. Pressing the lever with your elbow releases a portion of the liquid.

A hand disinfectant (abbreviation HDM ) is a liquid with which the hands are rubbed over a certain period of time. With this hand disinfection process , the germ colonization on the skin of the hands is largely reduced by killing or deactivating bacteria , fungi and viruses , for example, depending on the preparation used. Suitable skin-friendly disinfectants are the most effective means in doctor's offices, clinics and nursing homes to prevent the transmission of germs from one patient via the staff to other patients or to prevent cross-infection .

In addition, hand disinfectants for private use are sold by drugstores and pharmacies in gel form or as wet wipes.

Components

Solutions for hand disinfection are available as ready -to-use alcoholic preparations - in some cases in standardized containers - or, under certain conditions, are prepared from individual components for immediate use.

In 2010 the World Health Organization (WHO) published a guide to the manufacture of alcohol-based hand sanitisers in local pharmaceutical facilities. Local production of hand disinfectants is recommended by the WHO in the event that ready-made products are not available or too expensive.

Finished preparations

The main ingredients in hand disinfectants are alcohols ( ethanol , 1-propanol or 2-propanol (isopropanol)). Products with 60% to 95% alcohol by volume are most effective. Higher or lower concentrations are less effective. The most common concentrations are between 60% and 80% alcohol.

In addition to alcohol, hand sanitisers also contain:

Basic ingredients for preparation

Solutions based on chlorine or peroxyacetic acid are not available as ready-to-use preparations, but must be freshly prepared immediately before use and disposed of after the maximum storage time specified by the manufacturer. Because of their poor compatibility, these substances are rarely used as HDM. The Disinfectant Commission of the Association for Applied Hygiene (VAH) advises against using products containing chlorine with sodium hypochlorite due to the instability and possible skin irritation.

development

The physician Ignaz Semmelweis was the first to successfully use the disinfectant chlorinated lime : The doctors under his control had to dip their hands in this special solution, which initially caused ridicule among colleagues. However, this measure significantly reduced the mortality of women who have recently given birth . However, chlorinated lime not only attacks bacteria and viruses, but also the skin. Due to the poor tolerance, the willingness to use it regularly was low. The modern alcohol-based preparations, the development of which goes back to Peter Kalmár in the 1960s, are much gentler on the skin. Many nosocomial infections could be prevented if medical staff carried out hygienic hand disinfection before and after each patient contact .

In Germany, only tested and listed hand disinfectants are permitted in medical practices, hospitals and other medical care facilities. For private use, on the other hand, there are various gel-like liquids and wet wipes on the market, which differ in composition and spectrum of activity from the listed agents.

Effect restrictions

Some of the preparations used have no effect on spore formers, ectoparasites and on certain, in particular non-enveloped viruses such as noro- and rotaviruses. These pathogens, which are responsible for many infections with vomiting, diarrhea (also known as gastrointestinal flu or gastroenteritis ), are fought with special hand disinfectants. In 2017, another area of ​​activity for hand disinfectants was defined with the designation limited virucidal plus . For enveloped viruses, the HDM must therefore be marked as limited virucidal , for non- enveloped viruses such as noro-, adeno- and rotaviruses as limited virucidal plus , for other non- enveloped viruses such as e . B. Polioviruses as virucidal .

The Disinfectant Commission of the Association for Applied Hygiene (VAH) advises against using ready-made alcohol-soaked wipes for hygienic hand disinfection in the healthcare sector, as they are not reliably effective. B. significantly less active ingredient solution than with the usual hand disinfection methods, so that there may be no uniform wetting of the entire hand; In addition, there is no kneading movement with which the active ingredient solution is pressed into the nail folds. As an unfavorable side effect, the VAH also cites the significantly increased amount of waste caused by the wipes - compared to the established process.

The products for private use often do not offer any hygienic advantages other than regular washing with soap and water; the advertised antibacterial effectiveness has not been proven for every preparation. Therefore, according to the Federal Institute for Risk Assessment (BfR) , the products can not be used universally and must be checked before use to determine what dose and after what exposure time the agents have an antibacterial effect. This can hardly be guaranteed in private households.

Dispenser equipment

The hand disinfectant is usually bottled in a so-called euro bottle. The usual formats are 500 ml and 1,000 ml containers. Other sizes, such as the compact pocket bottle, are also used. The Euro bottles are used together with a dosing pump and in most cases in a hand disinfectant dispenser that is permanently mounted on the wall. The preparation is dosed manually by operating a control lever or, in the case of automatic dispensing systems, it is dispensed via a sensor. Dosing pumps, which are screwed onto the euro bottle after removing the cap, are another alternative. These are used in an appropriate construction or placed on a horizontal surface. In this variant, plastic pumps are usually used, which are operated via the pump head.

Disinfectant dispensers must be kept in close proximity wherever hand disinfection has to be carried out. For hospitals, the Commission for Hospital Hygiene and Infection Prevention at the Robert Koch Institute (KRINKO) recommends a bed-near minimum equipment with one dispenser per patient bed in intensive care and dialysis units, in non-intensive care units one dispenser for two patient beds and in the sanitary cell; also in the locks in front of intensive care units , isolation rooms and operating theaters. In certain areas, patients may be at risk from the disinfectant (e.g. in psychiatric wards or in patients with dementia), so it is better to use smock bottles and dispensers on the wardrobe or dressing trolley. If smock bottles are used, the hands are first moistened with the necessary amount of disinfectant, the bottle is closed and placed in the pocket; only then is the hand disinfected in order to prevent recontamination of the hands by touching the smock bottle.

Empty disposable containers are not refilled, but discarded.

In addition, KRINKO recommends for health care facilities that hand disinfectant dispensers should allow the use of products from different manufacturers: "It should be possible to use containers from different manufacturers."

literature

Web links

Individual evidence

  1. ↑ Guide to Local Production: WHO-recommended Handrub Formulations. P. 1; accessed on April 1, 2020.
  2. ↑ Guide to Local Production: WHO-recommended Handrub Formulations. P. 5; accessed on March 26, 2020.
  3. ↑ a b Pascal Bonnabry, Andreas Voss: Hand Hygiene: a Handbook for Medical Professionals . Ed .: Didier Pittet, John M. Boyce, Benedetta Allegranzi. John Wiley & Sons, 2017, ISBN 978-1-118-84686-5 , Hand Hygiene Agents, pp. 51 f .
  4. ^ Christian Jassoy, Andreas Schwarzkopf: Hygiene, Infectiology, Microbiology. Thieme, Stuttgart 2018, p. 195, ISBN 978-3-13-241368-9 .
  5. ↑ Quality label for purchasing hand disinfectants. Association for Applied Hygiene eV, Disinfectant Commission, April 28, 2020; accessed on May 10, 2020.
  6. ^ Andreas Schwarzkopf: Practical knowledge for hygiene officers , Verlag W. Kohlhammer, 2008, p. 125; ISBN 978-3-17-019849-4 .
  7. ↑ Federal Health Gazette 2017, 60: 353–363 DOI 10.1007 / s00103-016-2509-2
  8. ↑ Sample presentation for the KRINKO recommendation (2016) Hand hygiene, status 2017 , accessed on March 13, 2019
  9. ↑ Communication from the disinfectant commission in the VAH with the participation of the “4 + 4 working group”: Cloth systems for hand disinfection. Hyg Med 2017; 42-6; P. 104
  10. ↑ Excessive cleanliness. In: Öko-Test Ratgeber Kosmetik 2015 from June 5, 2015, pp. 145–149.
  11. ↑ Sample presentation for the KRINKO recommendation (2016) Hand hygiene, p. 14 ; accessed on March 13, 2019
  12. ↑ Sample presentation for the KRINKO recommendation (2016) Hand hygiene, p. 15 ; accessed on March 13, 2019
  13. ↑ Sample presentation for the KRINKO recommendation (2016) Hand hygiene, p. 16 ; accessed on March 13, 2019