Questions About PD
We thank you for your question. The Centers for Disease Control and Prevention (CDC) has extensive guidelines on this topic (1). I’m not too certain if you were asking about bar soap vs. foaming handwash from a dispenser, or liquid soap vs. foaming soap from a dispenser. Thus, I will try to cover all these options.
- Bar soap is acceptable, but small sizes of bar soap are recommended, these should be changed frequently, and the soap should rest on a soap rack so that it can dry out between uses. Note, bar soap has been shown to harbor bacteria. (2)
- There is limited information on the effectiveness of liquid hand soap versus foam soap from dispensers for hand hygiene for health care personnel. One recently published study found foam soap less effective than liquid hand soap (3); however, foam soap is increasingly popular, may be preferred by personnel, and thus, would increase use (4). Much more research is needed on this topic. Liquid or foam soap should be used when hands are visibly soiled.
- If hands are not visibly soiled, alcohol-based hand rubs (ABHRs) (with alcohol concentrations between 62% and 95%) are described as being more effective than either plain or antimicrobial soaps over a broad range of testing conditions. They are available as rinses, gels and foams (2). A recent study found no difference in efficacy and drying times among the different types of ABHRs (5).
Irritant contact dermatitis (ICD) is the most frequently occurring adverse reaction to hand hygiene products. Alcohol-based hand rubs, many of which contain emollients, are associated with less irritant contact dermatitis than soap and water handwashing. In general, recommendations are that health care workers should be involved in decisions about preferences for hand hygiene products (there are so many different ones available today) (2).
- Centers for Disease Control and Prevention. Guideline for Hand Hygiene in Health-Care Settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. MMWR 2002;51(No. RR-16):[inclusive page numbers]. Updated 2017. http://www.cdc.gov/handhygiene/providers/index.html
- Ellingson, K. et al. Strategies to prevent healthcare-associated infections through hand hygiene, Infection Control and Hospital Epidemiology August 2014; 35(8): 937-960.
- Dixon N., Morgan, M. Foam soap is not as effective as liquid soap in eliminating hand microbial flora. American Journal of Infection Control 2017; 45: 813-4.
- John D. Hines, J. D., Alper, P. Letter to the editor regarding “Foam soap is not as effective as liquid soap in eliminating hand microbial flora” American Journal of Infection Control 2017; 45: 1411-1415.
- Wilkinson M et al. A comparison of the efficacy and drying times of liquid, gel and foam formats of alcohol based hand rub. Journal of Hospital Infection 2017. Sep 30.