Hands, whether gloved or ungloved, are several ways of spreading infection or for transferring microbial contamination. The use of hand disinfectants is the main process of good contamination control for personnel getting work done in hospital environments, or those involved in aseptic processing and within cleanrooms. Although there are many different types of hand sanitizers available there are differences with their effectiveness and several do not fulfill the Western european standard for hand sanitization.
Personnel getting work done in private hospitals and cleanrooms carry various types of organisms on their hands and such organisms can be readily transferred from one individual to another or from person to equipment or critical surfaces. Such organisms are either present on the skin not increasing number (transient flora, which can include a ViroClear Hand Sanitiser range of environmental organisms like Staphylococcus and Pseudomonas) or are increasing number organisms released from the skin (residential flora including the genera of Staphylococcus, Micrococcus and Propionibacterium). Of the two groups, residential flora are more difficult to remove. For critical operations, some protection is afforded by wearing gloves. However gloves are not suitable for all activities and gloves, if not regularly sanitized or if they are of an improper design, will pick up and transfer contamination.
Therefore, the sanitization of hands (either gloved or ungloved) is an important part of contamination control either in private hospitals, to avoid staff-to-patient cross contamination or prior to undertaking clinical or surgeries; and for aseptic supplements like the dispensing of medicines. Moreover, not only is the use of a hand sanitizer needed prior to undertaking such applications, it is also important that the sanitizer works well at eliminating a high population of bacteria. Studies have shown that if a low number of organisms continue after use of a sanitizer then the subpopulation can develop which is resistant to future applications.
There are many commercial available hand sanitisers with popular types being alcohol-based essential fluids or skin gels. As with other styles of disinfectants, hand sanitizers are competent against different organisms dependant on their mode of activity. With common alcohol based hand sanitizers, the mode of action leads to microbial cell death through cytoplasm seapage, denaturation of protein and eventual cell lysis (alcohols are one of the so-called ‘membrane disrupters’). The advantages of employing alcohols as hand sanitizers will include a relatively low cost, little aroma and a quick evaporation (limited continuing activity results in shorter contact times). Furthermore alcohols have a proven cleansing action.
In selecting a hand sanitiser the drug organisation or hospital will need to consider if the application is to be built to human skin in order to gloved hands, in order to both, and if it is required to be sporicidal. Hand sanitisers fall into two groups: alcohol based, which are more widespread, and non-alcohol based. Such considerations impact both upon cost and the safe practices of the staff using the hand sanitiser since many commonly available alcohol based sanitisers can cause excessive drying out of the skin; and some non-alcohol based sanitisers can be irritating to the skin. Alcohol hand sanitizers are made to avoid irritation through possessing hypoallergenic properties (colour and perfume free) and ingredients which afford skin protection and care through re-fatting agents.
Alcohols have a long history people as disinfectants due to inherent antiseptic properties against bacteria and some trojans. To be effective some water is required to be combined with alcohol to have to put out effect against organisms, with effective range falling between 60 and 95% (most commercial hand sanitizers remain 70%). The most popular alcohol based hand sanitisers are Isopropyl alcohol or some form of denatured ethanol (such as Industrial Methylated Spirits). The more common non-alcohol based sanitisers contain either chlorhexidine or hexachlorophene. Additives can also be included in hand sanitizers in order to increase the antimicrobial properties.