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fluid vs gel efficacy

fluid vs gel efficacy

Fluid vs Gel - the evidence

In the seminal paper on the topic comparing the effectiveness of fluids vs gels (Dharan S et al. Comparison of waterless hand antisepsis agents at short application times:raising the flag of concern. Infection Control and Hospital Epidemiology, 2003, 24:160-164. https:/www.cambridge.org/core/terms. https://doi.org/10.1086/502182) it was clearly shown in all test cases, that a fluid rise has far greater efficacy than a gel equivalent.

It is not known precisely why but it is suspected that the gel does not allow the active substance (ethanol) to have surface skin contact as quickly and for as long.

While high quality gel brands must pass the same tests and show the same efficacy as fluids, the user in practice often does not follow the manufacturer instruction and rub hands for say 60 seconds. In real life, users will rub only for 15 seconds (confirmed in numerous observational studies summarised in the 216 page report on world alliance for patient safety titled 'WHO Guidelines of Hand Hygiene in Health Care') and this short contact time, according to this landmark paper on the topic is the postulated rationale as to why fluids are more effective than gels and why this peer-reviewed pulished paper recommends that gels are not suitable for hospital settings where cross-transmission to vunerable patients is high.

Similar results were found in a second associated study the year earlier: Kramer A et al. Limited efficacy of alcohol-based hand gels. Lancet, 2002, 359:1489-1490

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