a) Hand

i. Hands represent the body parts that are the most frequently cleaned
during a day. In addition to simple cleansing, hand washing has an
essential role in infection control.
ii. According to the US Centers for Disease Control and Prevention
(hereinafter referred to as the “CDC”),
1. if soap and water are not available, alcohol-based hand sanitizers
should be used to clean the hands.
2. It should also be kept in mind, however, that cleansing the hands
without moisturizing them afterward will damage the skin barrier
and lead to dry skin symptoms.

iii. Hand cleansing products

1. include bar soaps, liquid soaps without and with antibacterial
agents, hand cleansing wipes, as well as alcohol-based and non-
alcohol-based hand sanitizers.

a) Topical Antiseptic (Antimicrobial)

i. Products combine the cleaning action of the physical
removal of foreign materials with an antiseptic agent that
kills microorganisms.
ii. These products are primarily targeted toward reducing the
level of transient bacteria and viruses on the hands.

iii. E.g Povidon Iodine

1. Usually use by nurses and doctors in OR

b) Antibacterial hand sanitizers

i. are applied to dry hands followed by rubbing. These
products dry fast and rinsing is not necessary. Hand
sanitizer products are usually categorized according to their
alcohol content, based on this fact we can distinguish
between alcohol-based and water-based formulations

iv. CDC Recommendations on Proper Hand Hygiene

1. Hand washing done properly and regularly is considered to be
the gold standard for removing transient bacteria from the hands
and preventing the spread of infection and illness.
a) Resident flora
i. They are non pathogenic
ii. They are their to protect us in harmful bacteria

2. Although the public belief is that hand sanitizers may replace hand
washing, the CDC recommends that hand sanitizers should not
be used in place of soap and water but only as an adjunct. In
addition, it states that hand sanitizers may not be as effective when
the hands are visibly dirty. Even in healthcare settings, CDC
guidelines recommend soap and water on the hands that are visibly
soiled or contaminated with proteins, rather than using the alcohol-
based sanitizers. The reason for this is that alcohol cannot
adequately reduce a number of important pathogens. Fats and
proteins may not be visible on the hands, and these materials can
coat and protect pathogens from the action of alcohol and may
interfere with and neutralize alcohol efficacy. In addition, alcohols
have very poor activity against bacterial spores, protozoan oocysts,
and certain nonenveloped viruses. Soap, friction, and running water
effectively remove the fatty materials and reduce pathogens of
concern. Proper hand hygiene involves the use of soap and warm,
running water and rubbing the hands vigorously for at least 20
seconds.