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[Hand, skin and mucous membrane disinfection in medical and dental practice].

Disinfection of hands, skin or mucous membranes or the mere cleansing of hands have different functions, which should be differentiated clearly. With different cleansing methods dirt will be removed, whereas disinfection methods will eliminate microbial contamination or reduce the resident skin flora. Cleansing of hands removes only a very limited amount of microorganisms and cannot replace disinfection. Skin has to be disinfected when the integrity of the body is harmed. Depending on the tasks which are to be performed, sometimes an immediate onset of action and not a long duration of effect can be desirable. In other cases it is just the prolonged action, even with slow onset, that is required. Furthermore a long-lasting effect can be useful, when recontamination takes place later on. Skin disinfectants can be applied by spraying or swabbing. There are only limited data known over disinfection of mucous membranes and till now there exist no suitable test-methods. Experimental studies have shown no really convincing results, even though sometimes a sufficient disinfection could be seen in clinical practice. This is partly due to the bacteriostatic effect. The problematical nature of recontamination of mucous membranes is naturally very serious, but the adhesion of disinfectants due to the special conditions on mucous membranes usually rather bad. Which procedures have to be applied in particular cases has to be decided after weighting the risks against each other.