21 September 2008

Frequent and proper hand cleansing can significantly reduce transmission of disease, care must be taken against overwashing.

Two major groups of microorganisms are found on skin:

  • Resident flora : normally reside there
  • Transient flora : contaminants that are the primary cause of hospital infections from cross contamination in a hospital environmental.

Plain soap and water can physically remove one level of microbes, and in fact may aid in the dispersal of bacteria on the skin of the hands. In order to kill microorganisms an antiseptic agent is necessary. Such cleaners typically contain alcohol and additional antimicrobial agent.

Alcohol cleaners may be too defatting and cause irritant contact dermatitis, especially when followed by soap and water cleansing. In additional to alcohol solutions, several other antibacterial agents are used. These include :

  1. Chlorhexidine gluconate. It’s cationic, and formulation containing anionic and nonionic emulsifying agents may reduce its activity.
  2. Iodine and iodophors. They often stabilized with a polymer and an ethoxylated nonionic surfactant to reduce irritation from the iodine.
  3. Quaternary ammonium compounds. Among the most frequently used quaternary ammonium compounds arethe alkyl benzalkonium chlorides. They are not compatible with anionic surfactant.
  4. Triclosan. IT’s nonionic and can be formulated with a variety of surfactants. The activity level of triclosan can be affected by the micelles formed by the surfactant.

Work site cleaners many be caustic and abrasive, they may contain sensitizers such as lanolin or limonene, or perfumes, and they may contain irritants such as alcohol. Antibacterial cleanser formulations containing alcohol are very typical of those that are used in medical facilities.

Anionic and cationic surfactants are more harmful than nonionic surfactants, and increased concentration of surfactant cause severe damage to the skin. The normal pH of the skin is in the range of 4.5 to 5.5, and hand and foot cleaners and treatment products can help maintain the health of the skin when they are formulated to be pH neutral to mildly acidic. Protein denaturation by the adsorption of the surfactant onto charged sites on the skin is a major factor in deciding which surfactant to use. The ability of the surfactant to adsorb onto the skin and penetrate cell membranes seems to determine degree of skin irritation.

For anionic surfactants of the series C12H25(OC2H4)XSO4Na, no denaturation occurs when X= 6 or 8. The addition of cationic surfactants to anionic surfactants tends to reduce their degree of irritation. Specific cleaners for home that recommends to use:

  1. Use soap and running water
  2. Rub your hand together, creating friction
  3. Wash all surfaces of your hands, including the backs of hands, wrists, between fingers, and under fingernails
  4. Wash hands for at least 60 sec
  5. Rinse well
  6. Dry the hands with a paper towel
  7. Turn the faucet off with a paper towel instead of bare hands.

Liquid cleansing product with a broad spectrum bactericide.

Active ingredient : Benzalkonium chloride
Inactive ingredient : water, cocaminopropyl betaine, propylene glycol, allantoin, cetrimonium chloride, quaternium 12, cocaminopropylamine oxide, diazolidinyl urea, quaternium 15, methyl paraben, propyl paraben, coloring agent, fragrance, TEA, citric acid.

Combination of surfactants (cocaminopropylamine oxide, cocaminopropyl betaine, cetrimonium chloride) improves the permeation of the active ingredients, and the presence of a keratolytic agent such as allantoin further enhances the activity of the benzalkonium chloride.

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