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DOI: 10.1055/s-2008-1077610
© Georg Thieme Verlag KG Stuttgart · New York
Sauber macht krank – Das Zusammenspiel von Händehygiene und Handekzemen
Cleanliness Turns into Illness – The Interconnection of Handhygiene and Hand ExcemaPublication History
Publication Date:
08 October 2008 (online)
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Zusammenfassung
Für Mitarbeiter in medizinischen Berufen gehören irritative Hautveränderungen an den Händen sowie Handekzeme zum Alltag. Ursächlich sind nicht zuletzt Maßnahmen der Händehygiene. Von vielen Mitarbeitern im Pflegeberuf werden insbesondere die alkoholischen Händedesinfektionsmittel für ihre rauen Hände verantwortlich gemacht, nicht selten werden sogar Allergien gegen die Alkohole vermutet. In ausführlichen allergologischen Testungen konnte diese Vermutung widerlegt werden – Sensibilisierungen gegen die Alkohole wurden beim medizinischen Personal bislang nicht beobachtet, falls allergische Reaktionen vorkamen, dann gegen andere Inhaltsstoffe der Desinfektionsmittel. Auch in den Irritationstestungen konnte gezeigt werden, dass die alkoholischen Händedesinfektionsmittel in aller Regel gut vertragen werden, zumindest deutlich besser als die Händewaschung mit Detergentien. Der Grund, warum viele Pflegedienstmitarbeiter so negativ gegen die Händedesinfektion mit alkoholischen Produkten eingestellt sind, ist, dass die Präparate auf vorgeschädigter Haut ein brennendes Gefühl verursachen. Dieses Gefühl führt dazu, dass die alkoholische Desinfektion zugunsten des Händewaschens vernachlässigt wird, was dann wieder den Hautzustand weiter verschlechtert. Eine rechtzeitige Aufklärung der Mitarbeiter im Gesundheitsdienst über die Hautverträglichkeit von Händedesinfektionsmaßnahmen sollte bereits bei der Ausbildung erfolgen, um von Anfang an eine Schonung der Haut zu gewährleisten.
Abstract
Irritant skin changes and dermatitis on the hands of health care employees are quite common and belong to daily routine. Measures of hand disinfection are frequently accused of inducing these changes. Particularly the hand disinfection with alcohol based skin rubs is blamed to be responsible for their dry and scaly skin. Even allergic reactions to the hand rubs are assumed. In extensive testing, no allergic reactions to alcohols have been described so far. Only sensitization against other ingredients of alcohol based hand rubs have been found. The performed irritant patch testing as well as the in use tests of the alcohols have shown a remarkably good tolerance – far better than the one to hand washing with a detergent. The reason why many health care employees believe to have intolerance against alcohol based hand rubs is that they feel burning and stinging sensation after application of the product on hands with an impaired barrier. They accuse the alcohol based hand rub for this sensation and tend to use hand washing instead, which impairs their skin barrier more seriously. An educational teaching, most effectively during training, will help to avoid such behaviour and may help to maintain a good skin condition.
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Prof. Dr. Harald Löffler
Hautklinik
SLK-Kliniken
Am Gesundbrunnen 20–24
74078 Heilbronn
Email: Harald.Loeffler@slk-kliniken.de