[Hygienic and dermatologic aspects of hand disinfection and prophylactic skin antisepsis].

Hygienic hand disinfection must be carried out after all patient-care activities associated with contamination risks, as well as when moving from contaminated to clean body sites, after contact with environmental surfaces in the immediate vicinity of patients, after glove removal and before aseptic procedures. Preparatory handwashing (for about 10 seconds) to mechanically remove soil and bacterial spores should be performed at least 10 minutes before surgical hand disinfection. This allows time for the normalization of increased skin hydration, a prerequisite for effective hand disinfection. Depending on the manufacturer's instructions, application times of 1.5, 3 or 5 minutes can be observed. The regular use of skin care and skin protection products can help to prevent toxic skin irritation. For skin antisepsis the recommended exposure times are > or =15 seconds before subcutaneous injections, > or =1 minute before puncture of joints and body cavities as well as preoperatively, and > or =10 minutes on skin areas rich in sebaceous glands. For all 3 indications, alcohol-based formulations are the agents of choice.