Alcohol hand rub: liquid, gel or foam?

Correct hand hygiene is the one of the most effective actions in reducing the spread of infection. Hand hygiene includes applying an alcohol-based hand rub to the surface of hands (including liquids, gels and foams) or washing hands with the use of a water and soap or a soap solution, either non-antimicrobial or antimicrobial.

Hand Hygiene Australia (HHA) suggests that alcohol-based hand rub is the gold standard of care for hand hygiene practice in healthcare settings, whereas handwashing is reserved for situations when hands are visibly soiled, or when gloves have not been worn in the care of a patient.

When performed correctly, hand hygiene results in a reduction of microorganisms on hands and contributes to prevention of health care-associated infection and improved patient safety.

Based on substantial evidence, the 5 Moments for Hand Hygiene are designed to minimise the risk of transmission of microorganisms between healthcare worker, the patient, and the environment.

  1. Before touching a patient

  2. Before a procedure

  3. After a procedure or body fluid exposure risk

  4. After touching a patient

  5. After touching a patient’s surroundings

A study published in the Journal of Hospital Infection examined if there is any difference in efficacy between hand rubs containing alcohols that are in liquid, gel or foam form.

The researchers focused on alcohol-based hand rubs containing isopropanol or ethanol. To determine efficacy, they conducted tests on 20 volunteers with each person receiving 3 ml formulation of the liquid, gel or foam hand rubs. To determine drying time, researchers also tested 1.5ml and 3.0 ml of the three formulations. Volunteers self-reported when their hands were dry.

The study shows no difference in antibacterial efficacy between the three formulations. However, ethanol-based hand rubs tended to dry faster than isopropanol-based rubs. For both types of rubs, gels took longer to dry than other formulations.

Given that there is no difference in the efficacy of liquid, gel or foam hand rub, and the drying time was only marginally different, any form of alcohol hand rub can be used provided that it passes the required efficacy and safety standards!