Disease relevance of Handwashing

• A hand-disinfection system using an antimicrobial agent (chlorhexidine) reduces the rate of nosocomial infections more effectively than one using alcohol and soap [1].
• BACKGROUND: Routine handwashing has been proven to decrease incidence of health care-associated infections, including methicillin-resistant Staphylococcus aureus (MRSA), spawning numerous attempts to "advertise" its importance [2].
• After handwashing gram-negative bacteria were isolated from 75.1% of subjects; yeast from 32.9%; and Staphylococcus aureus from 18.5%, 1 of which (2.4%) was oxacillin-resistant [3].
• Dermatitis from Ammonyx LO, a constituent of a surgical scrub [4].
• A laboratory model for testing agents for hygienic hand disinfection: handwashing and chlorhexidine for the removal of Klebsiella [5].

High impact information on Handwashing

• Surveys of fecal coliforms on the hands of nursery personnel revealed no change in prevalence after introduction of a policy of "triple" handwashing with 3 percent hexachlorophene soap, but a significant decrease occurred during the use of disposable gloves [6].
• CONCLUSION: Within the ranges of parameters studied, the most effective strategies for reducing the rate of MRSA transmission were increasing the handwashing rates for visits involving contact with skin or bodily fluid and screening patients for MRSA at admission [7].
• STUDY DESIGN: This was a randomized controlled trial that compared 10% povidone iodine and 4% chlorhexidine gluconate as surgical scrubs [8].
• CONCLUSION: Hand-hygiene practices were improved with increased frequency of handwashing through increasing awareness of the importance of hand hygiene, and the use of alcohol gel hand sanitizer in university dormitories [9].
• An examination of the adenosine triphosphate (a measure of residual organic soil), bacterial, and staphylococcal load on ward handwash station surfaces, which could be touched during handwashing, is reported [10].

Chemical compound and disease context of Handwashing

• Human immunodeficiency virus (HIV), the etiological agent of the acquired immunodeficiency syndrome (AIDS), was treated with either Betadine (povidone-iodine) Solution or Betadine Surgical Scrub [11].
• Septisol Foam is an effective bacteriostatic agent that minimizes the risk of dermatitis and offers sufficient antibacterial protection without supplementary handwashing [12].

Biological context of Handwashing

• Seventy-four percent of the infection control personnel were aware of the compatibility issues of petroleum-based moisturizers with latex gloves, and 48% were aware of the need to avoid the use of anionic moisturizers in combination with CHG handwashing agents [13].
• The results of this study revealed that in order to attain effective disinfection with polyvidone iodine, the duration of handwashing should be at least 3 min [14].
• Usefulness of an alcohol solution of N-duopropenide for the surgical antisepsis of the hands compared with handwashing with iodine-povidone and chlorhexidine: clinical essay [15].
• A gas chromatographic (GC) method with flame ionization detection was developed to separate and quantitate p-chloroaniline (PCA) from other components in a chlorhexidine digluconate (CHG)-containing alcohol foam surgical scrub product [16].

Anatomical context of Handwashing

• Bacteriological samples were taken from the hands of the scrubbed team after surgical scrub but before putting on sterile gowns and gloves and from the patients' skin (incisional area of sternum and vein harvesting area of legs) after preoperative skin preparation with chlorhexidine gluconate [17].

Associations of Handwashing with chemical compounds

• CONCLUSIONS: In this evaluation of hand hygiene agents, handwashing with soap and water, 2% chlorhexidine gluconate, or chlorine-containing towels reduced the amount of B atrophaeus spore contamination, whereas use of a waterless rub containing ethyl alcohol was not effective in removing spores [18].
• The hand disinfectant was compared to agents in current use as surgical scrubs (4% chlorhexidine and 7.5% povidone-iodine) [19].
• Comparison of the immediate, residual, and cumulative antibacterial effects of Novaderm R,* Novascrub R,* Betadine Surgical Scrub, Hibiclens, and liquid soap [20].
• We evaluated the effects of an antimicrobial hand gel (containing 60% ethanol plus emollients) on skin condition when used as a supplement to handwashing [21].
• BACKGROUND: Since the introduction in the 1970s of surgical hand scrub formulations that contain 4% chlorhexidine gluconate (CHG), new surgical scrub formulations that have improved efficacy, persistence, or significantly improved use characteristics have not been forthcoming [22].

Gene context of Handwashing

• Recommendations for surgical hand disinfection -- requirements, implementation and need for research. A proposal by representatives of the SFHH, DGHM and DGKH for a European discussion [23].
• Handwashing practices and resistance and density of bacterial hand flora on two pediatric units in Lima, Peru [24].
• The alcohol solution of NDP was highly germicidal in vivo, destroying microorganisms better than classic handwashing on the hands of 69 health care staff of our NICU and PICU [25].
• Pre-surgical handwashing and disinfection procedures were identical in each case [26].
• The effects of 'in-use' surgical handwashing on the pre- and postoperative fingertip flora during cardiothoracic and orthopaedic surgery [27].

Analytical, diagnostic and therapeutic context of Handwashing

• The interview also addressed awareness of skin care issues involving the compatibility of moisturizers with latex gloves and handwashing agents that contain CHG [13].
• In a cross-over design, each volunteer carried out a surgical hand disinfection with the reference alcohol [n-propanol 60%, (v/v)] or Sterillium Gel [ethanol 85% (v/v)] for 3 min [28].
• The best methods to delay resistance include strict handwashing, careful control of antibacterials, restricting fluconazole use to those situations where it has been most clearly shown to be beneficial, and carefully monitoring patients in intensive care units [29].
• A double-blinded, randomized clinical trial of hands of primary caretakers in 238 inner city households was conducted in which effects of plain or antimicrobial (containing 0.2% triclosan) handwashing soap on bacterial counts of the hands were compared before and after a single wash and before and after handwashing following a year of product use [30].

References