Hand hygiene: antiseptic for permanent makeup artists

Valentina Malyuga, director of Dana Medical LLC, epidemiologist

Since hands are the main work tool of any beauty industry specialist, the issue of antisepsis is perhaps the most important for both the doctor (master) and the patient (client). But does everyone know how to properly approach the cleansing and disinfection of the skin of the hands in order to protect both themselves and those who come to you for the procedure? Unfortunately, no: many people think that just washing their hands is enough. In fact, everything is much more serious.

Continuing the topic of infection prevention , let's talk about the cleanliness of hands - the main tool in the work of a cosmetologist, permanent makeup or manicure master.

A person's health is largely determined by the cleanliness of his hands. But every day, every second, every moment we have to deal with the world of microbes around us. And very often - aggressive. After all, they are also fighting for their lives. Practically 80% of these contacts are on the skin of the hands. And a huge number of contagious diseases can be transmitted, spread precisely through the hands.

But there are categories of people, on the cleanliness of their hands not only their own health, but also the well-being of their loved ones, patients, clients depends. Professionals employed in the beauty industry belong to this group. After all, the hands of a cosmetologist, a master of permanent makeup or a manicure are the main tool in their work.

Cleanliness: Important

Hands must be clean. And not only visually. Even on thoroughly washed skin, germs remain. In medicine, it has already been proven that up to 50-85% (figures depend on the level of development in different countries) of hospital-acquired infections arose as a result of inadequate, improper disinfection of hands by medical staff. But many cosmetology, hairdressing services and procedures, according to the degree of infectious danger, in accordance with the requirements for observing precautionary measures during execution, are equated to medical manipulations. Judge, neither the cosmetologist or master, nor the patient or client is insured against microtraumas during procedures. As a result of minor scratches or wounds, you can get dangerous diseases such as:

- bacterial infections, including those caused by very drug-resistant staphylococci, streptococci, Pseudomonas aeruginosa and other microorganisms;

- viral infections (including viral hepatitis B and C, AIDS);

- fungal infections (dermatomycosis, candidiasis).

One of the most important preventive measures to break the chain of transmission of infectious diseases is the hygiene of the hands of personnel in the beauty industry. Caring for the skin of the palms and forearms is a professional duty. Human skin is inhabited by many microorganisms. Microtraumas, the smallest cuts, cracks are a potential reservoir of pathogens. Skin microflora can be divided into two large groups: resident and transient flora.

Focus on microorganisms

Resident microflora are those microorganisms that constantly live and multiply on the skin. As a rule, they are not pathogenic, but under certain conditions (for example, getting into the wound during the procedure) they can lead to infection and illness. That is, in most cases, the resident microflora does not cause pathological processes in patients with intact skin, but can cause an infectious process when it enters the sterile cavities of the human body or into wounds, cuts, scratches, etc. The resident microflora cannot be destroyed by ordinary hand washing or even antiseptic procedures, although the number of microorganisms is significantly reduced. Sterilization of the skin of the hands is not only impossible, but also undesirable, because the normal microflora prevents the colonization of the skin by other, much more dangerous microorganisms. Transient microflora - these are microorganisms (including pathogens) that are temporarily on the skin of the hands - they persist for a short time (rarely, as a rule, more than 24 hours). Such microflora is easily removed by hygienic washing with soap, soap with bactericidal additives or destroyed by using antiseptics. As long as these microbes remain on the skin, they can be transmitted to clients, patients through contact, and contaminate various objects. This circumstance makes the hands of personnel the most important factor in the transmission of infections.

Types of hand treatment

There are the following ways of processing the hands of personnel:

• hygienic handwashing: post-contaminated handwashing with liquid soap, antimicrobial hand detergent (bactericidal soap) against transient microorganisms. In the case of soap, there are two methods of removing contaminants - chemical and physical. The alkaline environment of soap can have a detrimental effect on microorganisms, and with the help of water and foam, dirt particles along with microbes are mechanically eliminated. It is also clear that the antimicrobial effect of soap with bactericidal additives is relatively stronger.

The widespread use of this method of hand disinfection, the habit of using it, and the relative cheapness are positive aspects of using soap. But with uncertainty about the purity of the water used and its lack, there can be no question of any effectiveness of hand disinfection. It is impossible to provide each workplace with hot and cold water supply so that the specialist can disinfect his hands using soap in all necessary cases. And this procedure takes quite a lot of time (given the necessary frequency of maintaining hand hygiene and the intensity of the work). Also, after washing your hands with soap, be sure to dry them. The question immediately arises about towels. The use of reusable ones is a real threat of re-contamination of hands with microbes (pathogenic microflora not only survives and persists on tissue, but also multiplies very well!). Electric towels, due to the peculiarities of their action, create air vortices, into the streams of which a huge army of pathogens rises from the surrounding space and, when drying hands, falls directly on them. And what is the result of the disinfection? To avoid re-microbial contamination after hygienic hand washing, it is necessary to dry with disposable towels.

It is important not to forget about washbasins, especially faucets - a favorite place for germs. After washing hands with liquid soap (in medicine, and similarly in cosmetology, the use of solid hand detergents is prohibited) and drying them with a paper towel (napkin), the tap is closed using the same towel (napkin). When performing hygienic hand washing, use only warm water (not hot and not cold!).

In addition, it has been proven that soap destroys the protective lipid layer of the skin and causes it to dry out. The consequence of this may be irritation of the skin, cracks, which are very often populated by pathogenic microorganisms, dermatitis.

Therefore, it is recommended to use the method of hygienic hand washing using soap, mainly only after visiting the toilet and with visible contamination.

In practice, taking into account the numerous results of scientific research, the treatment of hands with an antiseptic is more effective. To do this, the hands are wiped with a sufficient amount of antiseptic, the skin must be moist throughout the entire period of the required exposure. They pay special attention to the "critical" areas of the hands, which, due to physiological characteristics, are not sufficiently wetted by means: thumbs, fingertips, interdigital zones, nails, periungual ridges and subungual areas.

Distinguish between hygienic and surgical hand antisepsis. They differ in the breadth of processing, the time of the procedure and, accordingly, the exposure (the time required for the destruction of microorganisms). The list of antiseptics that can be used for hygienic or surgical antiseptics does not differ.

Hygienic hand antisepsis: hand treatment by rubbing a special antimicrobial agent (antiseptic) against transient microorganisms. The most commonly used method of hand disinfection in beauty industry establishments. A distinctive feature of antiseptics is that, for example, during the hygienic treatment of hands, the antiseptic substance itself is not absorbed and does not penetrate into the body, but it can remain at the site of its rubbing for quite a long time and has no (or practically no) side effects.

It is used: before the start of a work shift, before carrying out procedures, before and after working with a client, before contact and use of sterile instruments, materials, products, after working with contaminated material (for example, blood after cuts).

The sequence of actions for hygienic hand antisepsis

Standard procedure for treating hands with an antiseptic

• Stage 1: a minimum of 3 ml of antiseptic is poured into the recess of a dry palm and rubbed vigorously into the skin of the hands and wrists for 30 seconds.
• Stage 2: right palm on the left back of the hand, left palm on the right back of the hand.

• Stage 3: palm to palm - with fingers crossed.

• Stage 4: Outer side of the fingers (fingers bent) on the opposite palm.

• Stage 5: ring-like rubbing of the left thumb into the closed palm of the right hand and vice versa.

• Stage 6: ring-like rubbing with closed fingertips of the right hand on the left palm and vice versa.

Each of the six steps is repeated several times. During the entire time of rubbing the drug, the hands should be wet, after the end - dry.

Hygienic antiseptic with modern preparations takes very little time, its duration is only 30 seconds. But it's these seconds:

1. Protect you, keep you healthy.
2. Protect your clients.
3. Keep your loved ones healthy (you won't bring the infection home on your hands).

Surgical hand antisepsis: treatment of the hands of personnel before surgical (or equivalent cosmetic procedures and manipulations) interventions using a fast-acting antiseptic, aimed at destroying transient and reducing the amount of resident microflora.

Necessary : before carrying out manipulations, which, according to the technique, are equated to surgical interventions (skin, mucous incisions, piercing, tattooing, etc.).

To achieve the goals of surgical or hygienic antiseptics, there are very important requirements for their implementation:

- apply and rub the product only on dry skin;

- use the amount of antiseptic required for processing;

- use a dosing device (in case of surgical antisepsis - elbow dispensers);

- do not use wipes, washcloths, tampons, other items for applying funds (except when it is necessary to eliminate visible organic contamination, for which wipes moistened with an antiseptic are used);

- carefully observe the processing technique;

- observe the sequence of actions, dosage of funds and exposure time at each stage.

When choosing antiseptics, it is necessary to take into account some criteria that they must meet:

• a wide range and high level of antimicrobial activity (destruction of bacteria, viruses and fungi);
• the speed of onset of the disinfecting effect (hygienic antiseptic - from 30 seconds to a minute, surgical antiseptic - up to 5 minutes);
• lack of skin-irritating action, allergenic, general toxic effect;
• prolonged antimicrobial action.

Why should antiseptics be rubbed only on dry skin? The answer is very simple. To achieve an effective antimicrobial action, it is necessary to observe the disinfection regimen. And this is the concentration and exposure (the time during which the antimicrobial agent inactivates the infectious agent). Antiseptics are used undiluted, this is their effective concentration. Antiseptic needs only 3 ml, and on wet hands it is diluted. And there will no longer be the necessary concentration, the reliability of hand disinfection is very doubtful.

It should also be taken into account that the skin and mucous membranes are also inhabited by microorganisms. And of course, if you carry out procedures on a non-disinfected surface, you risk introducing an infection. If skin antisepsis is not carried out or insufficiently carried out, then the client can be infected even with a sterile instrument. Especially carefully and for a long time (up to 10 minutes) it is necessary to treat skin rich in sebaceous glands (face, chest, spine, armpits, inguinal regions). Many hand sanitizers can be used by clients, but this should be stated in the product guidelines.

In Ukraine, more than 50 antiseptic agents used for hygienic and surgical hand antisepsis are registered and allowed for use.

Choosing an antiseptic

Today, among antiseptics, alcohol-containing products are considered to be the most relevant. Most often, ethyl, propyl and isopropyl alcohols are used as active substances for alcohol antiseptics. The disinfecting effect of these alcohols occurs very quickly and meets the requirements put forward. Composite antiseptics are used to enhance the antimicrobial effect. For example, a combination of different alcohols, alcohols with other active substances (quaternary ammonium compounds, biguanidines, polyguanidines). "Aniosgel", "Aniosrab", "BacterioSol", "Dezoderm", "Dermalong", "Inol", "Quiccid", "Lumaks-Profi Maxi", "Sensiva", "Septoderm", "Sterillium Classic Pur", " Emital-Protect Maxi” are just some of the officially approved alcohol antiseptics. Alcohol antiseptics can and should also be used to disinfect the skin of patients before various cosmetic manipulations and procedures, etc.

In Ukraine, a number of alcohol-free antiseptics based on quaternary ammonium compounds (QACs), guanidines and biguanidines (chlorhexidine digluconate, octenidine dihydrochloride), polyguanidines (polyhexamethylene guanidine chloride, polyhexamethylene biguanidine chloride, polyhexamethylene guanidine phosphate) have been successfully used for a long time and successfully. Among them are "Biopagdez antiseptic tonic", "DezOR", "Miramistin", "Octenisept", "Citeal" and other antiseptics of this series. It is not without reason that antiseptics based on polyguanidines are considered promising, which are applicable for both hygienic and surgical treatment of hands, as well as skin and mucous membranes of patients and clients. Unlike alcohol, they do not have a tannic effect on the skin and mucous membranes. And due to the peculiarities of the impact on the microbial cell, such antiseptics have a rather long antimicrobial effect, which contributes to long-term protection against pathogenic agents. They do not dry the skin and stabilize the water-lipid balance, which makes it possible to use such drugs for a long time. The skin and mucous membranes are disinfected with the indicated antiseptics, and antiseptics based on polyguanidines are also used to treat hands. They accelerate the healing processes in the treated tissues.

The complex of hygiene measures must necessarily include measures for the care of hands. Note that the hand sanitizer consists not only of active substances, but also of other components. The formulation necessarily includes components that provide care and protection against chemical influences. Such substances are an expensive part of the antiseptic. But even after the highest quality good antiseptics, it is necessary to resort to the additional use of protective creams, emulsions, which will preserve the skin of working personnel and prevent unwanted possible effects after the use of disinfectants.

Hand antisepsis is the most effective and economical way to prevent infectious diseases. And the use of high-quality, easy-to-use and effective modern antiseptics will ultimately preserve the health of staff, customers and patients, and help create a positive image of the institution.

The material was first published in Permanent No. 3/2016