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PubMed2004

Eradication by surfactant irrigation of Staphylococcus aureus from infected complex wounds.

Treatment of infected orthopaedic hardware usually requires the removal of the appliance. When the device is removed and immediately replaced, persistent infection frequently complicates this exchange procedure. We modeled the exchange procedure in rats by passing a wire suture through a posterior spinous process and then contaminating the wound with Staphylococcus aureus. We then investigated whether a sequence of surfactant enriched irrigation solutions (Castile soap followed by benzalkonium chloride, sequential surfactant irrigation) had a greater capacity to eradicate Staphylococcus aureus from the experimental wound than did the standard wound irrigant, normal saline. When we left the wire in place through the 2-week course of the study, sequential surfactant irrigation showed only a modest advantage over normal saline (staphylococci recovered from 39% versus 58% of wound cultures respectively). Simple removal of the wire 24 hours after implantation and bacterial contamination prevented wound infection in most animals (with the wire removed, 38% of the animals remained infected versus 85% with the wire left in place), without regard to the irrigation solution. Alternatively, when we removed the wire after 24 hours, irrigated the wound, and then placed a fresh wire back into the wound, sequential surfactant irrigation showed a significant advantage over NS (54% of the animals irrigated with sequential surfactants remained infected versus 100% of the animals irrigated with normal saline). Our findings confirm the importance of a contaminated medical device for promoting foreign body infection; our findings also show that sequential surfactant irrigation has therapeutic value in a rat model of orthopaedic device infection; this irrigation protocol should be studied further as a potential agent for the treatment of infected orthopaedic wounds.

Animals↗
PubMed2000

Particle diffusion in a quasi-two-dimensional bacterial bath.

We study the effect of bacterial motion on micron-scale beads in a freely suspended soap film. Given the sizes of bacteria and beads, the geometry of the experiment is quasi-two-dimensional. Large positional fluctuations are observed for beads as large as 10 microm in diameter, and the measured mean-square displacements indicate superdiffusion in short times and normal diffusion in long times. Though the phenomenon is similar to Brownian motions of small particles, its physical origin is different and can be attributed to the collective dynamics of bacteria.

Bacterial Physiological Phenomena↗
PubMed1977

Effects of prolonged continuous exposure of human skin to water: a reassessment.

Continuous exposure of human skin to water in small plastic cups for periods of 72 and 144 hr produced a mild, transient dermatitis in half the sites tested. The degree of dermatitis was only slightly greater at 144 than at 72 hr, and was unrelated to the pH of the water samples. Comparison of soap-pretreated to non-pretreated skin areas showed a significant tendency for the more severe dermatitis to be present on the non-pretreated skin areas at higher pH's. There was virtually no coating of hairs with waxy yellowish material (clumps of bacteria), and no lesion was produced that resembled warm-water-immersion injuries.

Adult↗
PubMed2005

Implementation of an occupational skin disease prevention programme in Danish cheese dairies.

The purpose of this study was to implement an evidence-based prevention programme to reduce occupational skin diseases in a wet work occupation by educational activities and elements from an occupational health-management system. The effects were studied by telephone interviews using a standardized questionnaire (NOSQ-2002) with trade-modified questions on work and exposure. The study population consisted of all employees at 5 cheese dairies. At baseline, October 2002, a total of 557 answered (83.8%). At follow up 1 year later, a total of 650 current and former employees answered (81.8%). At 4 of the 5 dairies, the eczema frequency at baseline was relatively low (11.8% and 5.9% at intervention dairies; 7.0%, 10.4% and 33.3% at comparison dairies). On all the studied dairies, about one-third of the workers reported having 2 or more skin symptoms at baseline. At follow up, skin symptoms were reduced significantly on all dairies. Effects restricted to the intervention dairies included significant increases in the use of gloves and moisturizers. The comparison dairy with high eczema frequency at baseline introduced skin-care products, changed hand soap and mowed employees with skin problems, away from adverse working areas during the intervention period, and the frequency of eczema was significantly reduced at follow up.

Adult↗
PubMed1993

A study of the efficacy of antimicrobial detergents for hand washing: using the full-hand touch plates method.

We studied the effects of four kinds of antimicrobial detergents, 4% chlorhexidine gluconate (CHG), chlorbenzarconium (CBC), 10% povidone-iodine (PVI), 0.3% triclosan (TRI), and one non-medicated detergent (NMD) using the full-hand touch plates method. Before and after 3 minutes of hand scrubbing with a brush, bacterial colonies on the hand surface and subungual bacteria were counted. CHG, CBC, and PVI were excellent antimicrobial detergents against hand surface bacteria, but most of the subungual bacteria remained. The subungual space was the most difficult region from which to eradicate bacteria. TRI was much less effective than hand soap against hand surface bacteria.

Adult↗
PubMed1975

One hundred twin pairs patch tested with primary irritants.

The cutaneous sensitivity to benzalkonium chloride, sodium lauryl sulphate and potash soap was determined in 54 monozygotic and 46 dizygotic twin pairs. Comparing the intra-pair reaction strength a higher degree of concordance was found among monozygotic than among dizygotic twins, and even more so when monozygotic twins were compared with matched controls.

Adolescent↗
PubMed1975

Comparison of allergenicity of a perfume in animals (guinea pig maximization test) and in humans (usage test).

Using the Guinea Pig Maximization Test, the sensitization rate of a perfume was shown to be 10 per cent, which means a mild allergenicity rate. A usage sensitization trial was performed with the same perfume included in a soap, on 300 persons for 2-3 months. Seventy-five of these, all house-wives, were randomly selected and tested epicutaneously, after the trial. One woman reacted allergically towards the perfume. This means a sensitization rate of 1.3 per cent, which is a maximum value, as she could, theoretically, have been sensitized before.

Animals↗
PubMed2004

A systematic review on the effectiveness of alcohol-based solutions for hand hygiene.

The use of alcohol has been proposed as an option for hand hygiene. A systematic review was conducted to evaluate the clinical evidence supporting the use of alcohol-based solutions in hospitals as an option for hand hygiene. Studies published between January 1992 and April 2002 in English and Thai, related to the effectiveness of alcohol-based solutions, were reviewed. The databases searched included Medline, DARE, CINAHL and Dissertation Abstracts International. All studies were assessed as having adequate methodological quality. Results of this systematic review supported that alcohol-based hand rubbing removes microorganisms effectively, requires less time and irritates hands less often than does handwashing with soap or other antiseptic agents and water. Furthermore, the availability of bedside alcohol-based solutions increases compliance with hand hygiene among health care workers.

Alcohols↗
PubMed1993

Misunderstanding of cosmetic products: a paradigmatic clinical case in a baby.

A 6-month-old baby had erythema, fissuring of the skin, and craquelé due to prolonged use of a liquid soap mistakenly believed to be a moisturizer. We think these kinds of skin disorders will become increasingly common due to such misunderstandings. The proliferation of cosmetic products for baby skin care, the increasing prescription of cosmetics by dermatologists for skin disease, and the increase in kinds of cosmetics with similar or unusual contents all encourage such accidents.

Erythema↗
PubMed1994

Dansyl chloride labelling of stratum corneum: its rapid extraction from skin can predict skin irritation due to surfactants and cleansing products.

The irritation potential of surfactants and body cleansing products was determined by evaluating the removal of dansyl chloride from the skin. Dilute solutions (2% active ingredient, w/v) of surfactants and soap extract fluorescence from the skin within 30 min. This is probably a physicochemical effect as it is too rapid to be due to a modification of epidermal cell turnover rate. Such an extraction of the fluorescent dye occurs without any clinical sign of irritation. However, it may represent an early phase of the skin irritation process, because it is related to the ranking of irritant products as determined by other assessment methods.

Betaine↗
PubMed1995

Exposure characteristics and cutaneous problems in operating room staff.

Health care personnel have exposure to a variety of cutaneous irritants and allergens and a high prevalence of cutaneous problems. The objectives of this exploratory study were to characterize the exposures and determine the prevalence of cutaneous symptoms and findings in operating room personnel, and to examine relationships between exposure characteristics and cutaneous outcomes. A questionnaire and standardized hand examination were used to assess the exposures and cutaneous status of operating room personnel. 184 operating room staff (90% of the eligible population) were assessed. Current skin problems were reported by 26%. Hand examination revealed that 9% had findings consistent with eczema and 10% changes of moderate dryness. A variety of preventive practices were being used by those with symptoms or findings. Cutaneous problems are common in operating room personnel. The use of preventive strategies (changing the type of gloves worn or the type of soap used for scrubbing, the use of glove liners and emollients) varied between different groups. These workers might benefit from more education regarding cutaneous hazards, preventive stategies and the importance of appropriate investigation of these problems.

Adult↗
PubMed1995

Patch testing with fragrances: results of a multicenter study of the European Environmental and Contact Dermatitis Research Group with 48 frequently used constituents of perfumes.

The objective of this study was to determine the frequency of reactivity to a series of commonly used fragrances in dermatological patients. A total of 48 fragrances (FF) were chosen, based on the publication of Fenn in 1989 in which the top 25 constituents of 3 types (1. perfumes, 2. household products, 3. soaps) of 400 commercial products on the US market had been determined. In a pilot study on a total of 1069 patients in 11 centres, the appropriate test concentration and vehicle were examined. For most fragrances, 1% and 5% were chosen, and petrolatum proved to be the best vehicle in comparison to isopropyl myristate and diethyl phthalate. In the main study, a set of 5 to 10 fragrances at 2 concentrations was patch tested in each centre on a minimum of 100 consecutive patients seen in the patch test clinic. These patients were also patch tested to a standard series with the 8% fragrance mix (FM) and its 8 constituents. In patients with a positive reaction to any of the 48 FF, a careful history with regard to past or present reactions to perfumed products was taken. A total of 1323 patients were tested in 11 centres. The 8% FM was positive in 89 patients (8.3% of 1072 patients). Allergic reactions to the constituents were most frequent to oak moss (24), isoeugenol (20), eugenol (13), cinnamic aldehyde (10) and geraniol (8). Reactions read as allergic on day 3/4 were observed only 10X to 7 materials of the new series (Iso E Super (2), Lyral (3), Cyclacet (1), DMBCA (1), Vertofix (1), citronellol (1) and amyl salicylate (1)). The remaining 41 fragrances were negative. 28 irritant or doubtful reactions on day 3/4 were observed to a total of 19 FF materials (more than 1 reaction: 5% citronellol (2), 1% amyl salicylate (2), 1% isononyl acetate (3), 0.1% musk xylol (2), 1% citral (2), and 1% ionone beta (2)). Clinical relevance of positive reactions to any of the FF series was not proved in a single case. This included the 4 reactions in patients who were negative to the 8% FM. In conclusion, the top 25 fragrances commonly found in various products caused few reactions in dermatological patients and these few appeared to be clinically irrelevant, with the possible exception of Lyral. However, this data should be interpreted in the light of the relatively small number of patients tested (only 100 in most centres).

Acrolein↗
PubMed1997

Regional differences in stratum corneum reactivity to surfactants. Quantitative assessment using the corneosurfametry bioassay.

The skin does not react similarly to the presence of xenobiotics over all anatomic sites. Distinct regional differences have been described for irritancy and percutaneous absorption. The present study assesses the regional variation of stratum corneum reactivity to surfactants using the corneosurfametry bioassay. Stratum corneum was harvested from 6 body sites in 20 young adults. Corneosurfametry was performed using water, 1% SLS and a 5% soap solution. Data show that the best variable to assess regional variability in irritancy is the overall difference in corneosurfametry (ODC), comparing the effect of a given surfactant with water. The dorsal hand and volar forearm were the least reactive, the neck, forehead, back and dorsal foot the most reactive, sites. It is concluded that the corneosurfametry bioassay, through the ODC variable, is a practically noninvasive tool for the evaluation of regional variation in irritancy at the level of the stratum corneum.

Adult↗
PubMed1985

Comparative antibacterial effectiveness of seven hand antiseptics.

Seven hand antiseptics (alcohol-, iodophor- and chlorhexidine preparations) were compared for antibacterial effectiveness using finger-print contact sampling on blood agar in duplicate series with 18 students as test persons. Bacterial samples were obtained before and after handwashing (with unmedicated liquid soap) as well as after hand disinfection. Hibiscrub was tested without prewashing. The antiseptics were rubbed into the skin and the hands left uncontaminated for 2 min before sampling. Due to results showing unexpectedly low antibacterial effectiveness of 70% (v/v) ethanol, a series of supplementary experiments with ethanol (70% (v/v) and 80% (v/v] and isopropanol (60% (v/v] were performed with 10 laboratory staff-members. These experiments confirmed the previously demonstrated weak antibacterial effect of 70% (v/v) ethanol on the normal hand flora. Alcoholic chlorhexidine solutions and Hibiscrub were the only preparations that gave significant, mean reductions (97.9-99.9% and 80.3-93.4%, respectively) in the number of colony forming units. According to the present study, these are the only test preparations that can be recommended for presurgical hand disinfection, and when hand disinfection is needed in general dental practice.

Alcohols↗
PubMed1989

Standardized method for evaluation of hand disinfection by surgical scrub formulations.

A standardized protocol for the evaluation of hand disinfection by surgical scrub formulations was applied to volunteers in a multicenter trial. Povidone iodine (PVI), chlorhexidine (CHX), and a nonmedicated soap (NMS) were tested. The scrubbing procedure involved three daily hand washings for five consecutive days; surviving bacteria were counted daily after being collected in a suitable neutralizing solution. Immediate efficacy (IE), cumulative efficacy (CE), and remanent effect (RE) were calculated by reference to the control hand. Statistical analyses of IE, CE, and RE showed significant differences among the three scrub formulations. IEs of PVI and CHX were equivalent and different from IE of NMS; CE and RE of CHX were higher than those of PVI and NMS. On the basis of the statistical analysis, the population size required for further studies aimed at detecting significant differences between surgical scrub formulations could be estimated.

Adult↗
PubMed1973

Hand carriage of gram-negative bacilli and Staphylococcus aureus.

The influence of hexachlorophane disinfection on the bacterial hand flora of hospital personnel has been examined. Hexachlorophane effectively reduced the total number of bacteria and the staphylococcal carriage. Gram-negative bacilli were isolated from 18.8% of the personnel, and 13% of the carriers continued to carry Gram-negative bacilli for more than six months. The carrier rate was significantly higher among those using hexachlorophane detergents (20.8%) than among those using plain soap (14.1%). Prolonged hand carriage of Gram-negative bacilli was often associated with skin irritation, especially of the nailfolds. Hand carriage may be an important source of Gram-negative infections in hospital, and the increase in these infections may partly be due to extensive use of hexachlorophane preparations.

Bacteria↗
PubMed2007

Exit-site care in peritoneal dialysis.

Exit-site infection (ESI), tunnel infection and associated peritonitis are major causes of morbidity and catheter loss in chronic peritoneal dialysis patients. Meticulous exit-site care is vital in preventing ESI. Avoiding trauma to the exit-site and daily cleaning of the exit-site with a dedicated antimicrobial soap is essential for the longevity of the peritoneal dialysis catheter. Antibiotics cream and disinfectant agents including povidone-iodine, chlorhexidine, electrolytic chloroxidizing solutions (Amuchina 10% - ExSept Plus, Amuchina 5% - ExSept) are useful to keep the resident micro-organisms inhibited. ESI rates in peritoneal dialysis patients treated with Amuchina 10% (ExSept Plus) and Amuchina 5% (ExSept) for the exit-site care are similar or lower compared to povidone-iodine or chlorhexidine. Electrolytic chloroxidizing (Amuchina 10% - ExSept Plus and Amuchina 5% - ExSept) solutions for exit-site care are effective for prevention and treatment of ESI.

Anti-Bacterial Agents↗
PubMed1994

In vivo hydration profile in skin layers by high-resolution magnetic resonance imaging.

In recent years magnetic resonance imaging has become a very efficient tool for in vivo quantification of water content and water behavior in living tissues. We have applied this technique to the study of the in vivo hydration profile in heel skin layers by quantification of the mobile water proton density versus depth. Effects of a bath, a moisturizer and repeated soaping are present. Hydration profiles by magnetic resonance imaging delineate two different structures in stratum corneum: an outer layer where hydration can be modified by external mechanisms and an inner layer where hydration is not altered. The main interest of this method lies in the fact that the physical signal is exactly located, as spatial encoding is the basis of in vivo imaging. This method differs from other noninvasive methods which acquire an averaged signal from a nondelimited volume of interest.

Administration, Topical↗