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Hand Hygiene
You would think that with all the water used in handwashing our skin would always
be moist, as water is important to skin conditioning, but several events come into
play when discussing skin conditioning and hand hygiene in the healthcare setting.
The need to perform hand hygiene activities throughout the day with soaps, detergents,
alcohol-based rubs and antimicrobials sets the stage for local skin reactions. One
of the most frequent is irritant contact dermatitis which is simply an irritation
of the skin and should not be confused with an allergy. Symptoms can include redness,
chapping, chafing, dryness, scaling, cracking and subjective symptoms such as itching
and burning.
An irritant contact dermatitis is a surface condition affecting the skin. Avoiding
contact with the irritants, including glove powders, and maintaining a regular regimen
of proper skin care will help keep hands healthier and free of irritation. Damaged
skin more often harbors increased numbers of pathogens.
Moreover, washing damaged skin is less effective at reducing numbers of bacteria
than washing normal skin, and the number of organisms shed from damaged skin is
often higher than from healthy skin. Moisturizing is beneficial for skin health
and reducing microbial dispersion from the skin. These are important concepts when
discussing hand washing techniques and products for hand washing compliance and
skin care.
The National Health Interview Survey (NHIS 1988) reported the following percentages
of self-reported occupational contact dermatitis.
Occupation % Reporting Occupational Contact Dermatitis
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Physicians Dentists Nurses 5.6% Pharmacists Dieticians
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Healthcare therapists Technologists 3.5% Technicians
Assistants |
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(Lushniak)
These figures demonstrate that contact dermatitis is a significant issue in hospitals
across the country.
Any of the antiseptic agents used in healthcare can cause an irritant contact dermatitis.
It is most commonly reported with iodophors, but chlorhexidine, PCMX, triclosan
and alcohol-based products can also cause local skin reactions. Industry addresses
this issue by its continued improvement to products. Healthcare facilities utilize
a number of strategies to get products to HCWs that provide the efficacy necessary
to do the job, and they trial products for hand hygiene, hand care and gloving materials
to meet the needs of the staff.
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