Hand washing with plain soaps vs. antiseptic soaps
The following discussion regarding hand washing with plain soaps vs. antiseptic soaps was developed from reproducible studies
performed in a hospital environment with human patients. I could find few reports of evidence-based studies performed in veterinary
Hand washing with an alcohol-based antiseptic agent is recommended between patient contacts. To reduce occurrence of dry skin
and dermatitis associated with frequent use, select appropriate alcohol-based products that have been fortified with emollients,
humectants and/or other skin conditioners.
There is a concern that unnecessary use of antiseptic soaps may foster development of resistant microbes. If microbes are
exposed repeatedly to antiseptics that do not kill them, resistant microbes may develop. Therefore, when the sole purpose
of hand washing is to remove soil and transient organisms at home or in an environment other than hospitals or clinics, soap
is usually adequate. Antibacterial hand cleansers are not needed.
However, in a hospital environment, hand-washing with an antiseptic agent (alcohol-based hand-rub) is indicated:
- When there is heavy microbial contamination
- Before performing invasive procedures (biopsies, intravenous catheters, urinary catheters, etc.)
- Before contacting patients with wounds or immunosuppressed patients
- Before and after direct contact with patients with antimicrobial-resistant organisms
How can hand-washing compliance be improved?
Failure to wash hands is a complex problem that may be caused by a lack of motivation or lack of knowledge about the importance
of the procedure. It may be caused by obstacles such as understaffing, inconveniently located sinks, absence of paper towels,
unacceptable hand-washing products or dermatitis caused by previous hand washing.
The convenient placement of sinks maintained to provide proper water temperatures and pressure, and ready availability of
hand-washing products, including nail brushes, disposable paper towels and waste containers, may help promote frequent and
appropriate hand washing. In addition, busy hospital staff should understand and adhere to the concept that use of antiseptic
cleansing agents does not provide an acceptable alternative to consistent use of proper hand-washing technique.
Dr. Osborne, a diplomate of the American College of Veterinary Internal Medicine, is professor of medicine in the Department
of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Minnesota.