Ordinary soap or antiseptic products?
Hand-washing products for use in hospitals are available in several forms. Factors to be considered include the degree of
microbial killing desired and the acceptability, cost and ease of using them. Cost should not be the primary factor. If hands
are not visibly soiled, the CDC recommends routine use of an alcohol-based hand rub (or antimicrobial soap and water) to decontaminate
Hand-cleaning agents must be effective in removing transient micro-organisms, but must be mild to the skin after many applications.
It is important that the product be acceptable to the personnel who will use it. To maximize acceptance by hospital staff,
solicit their input, their preference of fragrance, feel and skin tolerance.
Plain soaps and detergents
Following CDC guidelines, we define plain soaps as detergents that do not contain antimicrobial agents, or that contain low
concentrations of antimicrobial agents that serve as preservatives. Hydrophilic and lipophilic components are contained in
plain soaps and can be divided into four groups of detergents:
1) anionic, b) cationic, 3) amphoteric and 4) nonionic. The cleansing activity of plain soaps is due to their detergent properties
which, when properly used, results in removal of dirt, soil and various organic substances. Hand washing with plain unmedicated
soaps (in bar, granule, soap-impregnated tissue or liquid form) and friction created by rubbing the hands together are sufficient
to remove most dirt, organic material and transient microorganisms. They contribute to hygiene primarily by aiding mechanical
removal of microbes during washing.
Liquid soap generally is easier to use than bar soap. In addition, when applied via an appropriate dispenser, liquid soap
minimizes the possibility of transfer of microbes by direct contact with a contaminated bar of soap. However, since liquid
soap containers can become contaminated and might serve as reservoirs of microbes, reusable liquid containers should be used
until empty and cleaned before refilling with fresh soap. Liquid soaps should not be used to refill a partially full dispenser.
Completely disposable containers obviate the need to empty and clean dispensers. Topping off dispensers can contaminate soap.
If bar soap is used, it should be kept in a self-draining holder that is cleaned thoroughly after use of each bar. Why? Because
bacteria generally multiply quickly in moisture. Use of small bars of soap is also recommended.
Antiseptic hand-washing agents contain relatively nontoxic and nonirritant antimicrobial materials that are sufficiently bland
to be safely applied to the skin. Most antimicrobial-containing hand-washing products are available as liquids and often contain
alcohols, chlorine, chlorhexidine gluconate, hexachlorophene povidone-iodine, quaternary ammonium compounds or triclosan.
These agents may kill microbes (microbicidal effect) or inhibit their growth (micobistatic effect), a process often referred
to as the chemical removal of microorganisms. Since their introduction, use of antimicrobial hand-washing agents has been
shown to be more effective in reducing the number of microbes on the skin than plain soaps.