Hand dermatitis is a very common and serious problem in nurses. The reported prevalence rate is 18% - 86%, which is mainly related to wet work, hand washing and wearing gloves. The World Health Organization (who) hand hygiene guidelines recommend alcohol based hand disinfectants, but medical staff may choose to wash their hands because of skin irritation or other skin problems. Kampfg and Loffler h summed up the problem, about 30% of medical staff have occupational hand dermatitis, mainly due to the irritant contact dermatitis caused by detergent, and the allergic reaction is extremely rare.

 

The main cause of irritant contact dermatitis is the frequent use of hand hygiene products, especially soap and other detergents. Frequent hand washing leads to progressive loss of lipid on the skin surface, and deeper damage to the skin surface, dry season and individual dry skin, which occurs faster. The resulting skin damage may have an irritating effect on all hand disinfectants.

 

Although alcohol based hand sanitizers are safer than detergents, they can also cause skin dryness and irritation. Prospective studies have shown that alcohol hand disinfectants containing humectants have significantly less skin irritation than detergents such as soap. After the first use of alcohol hand disinfectant, medical personnel with irritating skin may feel skin burn because their skin barrier itself has been damaged by hand washing or airtight gloves. This can lead to a vicious cycle that increases the frequency of hand washing by medical staff and reduces the frequency of hand disinfectant use.

 

To sum up, the correct use of alcohol based hand disinfectant can improve the skin condition of medical staff's hands compared with frequent hand washing. We can pay attention to the following aspects: 1. Promote the use of alcohol hand disinfectant containing humectant instead of detergent. 2. Choose products with small irritation, especially for sensitive skin. 3. Do not wash hands before and after using hand disinfectant. 4. Dry hands thoroughly before wearing gloves. 5. Use hand cream.