Real Benefits of Hand Hygiene Product Foaming Technology

BACKGROUND/OBJECTIVES: Healthcare workers are choosing foamed hand hygiene products because of their ease of use and free-rinsing characteristics. Unfortunately, foamed products can sometimes be less mild most likely due to poor surfactant selection. Hand hygiene products that cause skin irritation and dryness might deter healthcare workers from complying with good hand hygiene practices as outlined in the Guideline for Hand Hygiene in Health-Care Settings. The true benefit of foam technology is that it can provide extremely mild routine and antiseptic cleansers when formulated with the appropriate choice of surfactant ingredients and increased levels of moisturizing agents. Furthermore, increasing mildness in hand hygiene products does not necessarily interfere with their antimicrobial efficacy. To compare mildness and efficacy of foamed hand hygiene products containing various surfactant systems. METHODS: To determine efficacy, a randomized, double-blinded healthcare personnel handwash (HCPH) study was designed based on the procedures described in the Tentative Final Monograph for Healthcare Antiseptic Drug Products (TFM). Serratia marcescens was applied to the subjectsʹ hands prior to washing with a 0.75% triclosan foamed hand hygiene product or a positive control (4% chlorhexidine gluconate). The contamination/wash cycle was repeated 10 times. Log reduction was determined after cycles 1, 3, 7, and 10. A randomized, double-blinded forearm controlled application test (FCAT) study was designed to determine the effects of the foamed products on the moisture and barrier properties of the skin. Visual appearance, transepidermal water loss, and skin hydration were evaluated at baseline and after five days of treatment. RESULTS: In the HCPH study, the mild surfactant containing triclosan foam demonstrated a 2.81 log10 reduction after wash 1 and a 3.03 log10 reduction after wash 10 (p = 0.0001). Even with this demonstrated activity, the mild antimicrobial product minimized the drying effects of water when measured using a corneometer. The mildest routine product demonstrated increased moisture versus water alone. Additionally, the routine foaming product demonstrated no significant difference in moisture (p = 0.0250) compared to an untreated site. CONCLUSIONS: These data demonstrate that well formulated foaming hand hygiene products can be mild and in the case of antiseptic foam products can also meet the TFM criteria for a HCPH. Employee. STERIS Corporation