Liquid soap dispensers are used by millions daily, but as you reach for the soap dispenser to clean your hands you may want to look at the dispenser itself before pumping. All soap dispensers are not alike, and some can potentially harbor more bacteria than they remove!

Prevention Basics
Washing your hands with soap and water is universally considered one of the simplest steps you can take to avoid getting sick and spreading germs. This is especially important as flu season returns and COVID-19 rates continue to climb. But is the familiar wall mounted soap dispenser in the restroom or common area doing more harm than good? That may depend on what type of dispenser it is and how well it’s being maintained.

It’s What’s Inside That Counts
There are two common wall mounted soap dispensers: closed and open bulk-refillable systems. Closed liquid soap dispensers can be refilled with a sealed disposable bag or cartridge. Open bulk-refillable dispensers require soap to be poured into the dispenser from bulk stock soaps that may be concentrated, requiring tap water to dilute the soap.

Bulk-refillable soap dispensers are commonly found in public restrooms in many community settings. Recent studies have shown one in four bulk-refillable soap dispensers are contaminated.¹ While soap does not have to be sterile for effective hand washing, the number of bacteria in the soap needs to be minimal and free of harmful organisms. It should also contain enough preservative to prevent contamination of the soap.²

A study conducted in Japan examined contaminated soap dispensers and found 17 different species of bacteria, including Klebsiella pneumoniae, Serratia Marcescens, and Enterobacter, and Pseudomonas.¹ Various outbreaks have occurred from contaminated soap resulting in a variety of infections such as bacteremia, joint infections, skin ulcers, and urinary tract infections.²

As new soap is poured into the dispenser, contaminants such as dirt and bacteria can also be introduced during the refill process. Researchers also theorize that preservatives in bulk soap may deteriorate over time which can also lead to contaminated soap.²

Ideally, a refillable dispenser should be cleaned before filling. Wall-mounted dispensers may not have a removable soap container, so cleaning the container that houses the soap can be challenging and the effectiveness of cleaning short-lived. Studies show that even after cleaning a contaminated dispenser with a 10-minute soak of sodium hypochlorite (bleach) solution, the contamination levels return to pre-cleaning levels within 7-14 days.⁴

The Centers for Disease Control (CDC) discourages the practice of “topping off” or adding new soap to existing soap in the container due to the risk of contamination citing contaminates can enter the dispenser when the top is removed and new soap is added.³

How DermaRite Can Help You
DermaRite’s closed cartridge and bag systems are an easy solution to prevent liquid soap contamination. The disposable closed cartridge or bag provides clean, uncontaminated soap and a new nozzle for delivery of soap with every dispenser refill. A clean, mess-free system will enhance handwashing compliance.

DermaRite offers a variety of liquid hand soaps, hand sanitizers, and skin cleansers for use in a closed system refillable dispenser.

Our line of liquid hand soaps and total body cleansers include:

DermaKleen™: a pH balanced, Triclosan-free antiseptic hand cleanser enriched with vitamin E to soften and condition frequently washed hands. Contains chloroxylenol.
KleenFoam: a pH balanced antiseptic foam hand soap that moisturizes with Aloe Vera for clean, soft, conditioned hands. Contains chloroxylenol.
TotalFoam: a pH-balanced total body wash and shampoo enriched with Aloe Vera which offers a thick rich lather to leave skin soft and fresh.
TotalBath: a mild, pH balanced full body cleanser and shampoo enriched with vitamin E to moisturize and nourish skin.
DermaRain: a pH balanced, dye-free cleanser for sensitive skin that cleans and moisturizes without irritation.
DermaVera: a pH balanced cleanser enriched with shea butter to provide a rich lather with a fresh scent. Nourishes and moisturizes as it cleans.

References:

1. Zapka, Carrie & Campbell, Esther & Maxwell, Sheri & Gerba, Charles & Dolan, Michael & Arbogast, James. (2011). Bacterial Hand Contamination and Transfer after Use of Contaminated Bulk-Soap-Refillable Dispensers. Applied and environmental microbiology. 77. 2898-904. 10.1128/AEM.02632-10.
2. The Free Library. S.v. Occurrence of heterotrophic and coliform bacteria in liquid hand soaps from bulk refillable dispensers in public facilities..” Retrieved Dec 01 2020 from https://www.thefreelibrary.com/Occurrence+of+heterotrophic+and+coliform+bacteria+in+liquid+ha nd…-a0249684607
3. https://www.cdc.gov/mmwr/PDF/rr/rr5116.pdf
4. Lorenz LA, Ramsay BD, Goeres DM, Fields MW, Zapka CA, Macinga DR. Evaluation and remediation of bulk soap dispensers for biofilm. Biofouling. 2012;28(1):99-109. doi: 10.1080/08927014.2011.653637. PMID: 22257312.

Much of our focus in the year 2020 has been on preventing the spread of COVID-19, but the risks of infection and the need for infection control are not new. In healthcare settings we are continually challenged with preventing the spread of common organisms that cause disease and result in costly Healthcare-Acquired Infections (HAIs), such as Methicillin-resistant Staphylococcus Aureus (MRSA), Vancomycin-resistant Enterococcus, Clostridium difficile, often called C. diff., E. coli, as well as viruses causing flu, pneumonia and COVID-19.

The Staggering Impact of HAIs
The Center for Disease Control estimates that 1 in 25 hospitalized patients will get an infection contracted while in a healthcare facility and an estimated 75,000 patient deaths annually are a result of these infections¹. These infections carry an astounding price tag of over $9.8 billion to treat².

Who’s At Risk
HAI prevention is not a challenge exclusive to hospitals. It is a focus in Long Term Care (LTC) facilities, outpatient centers, medical offices and home-care settings. Estimates on the number of infections acquired in LTC facilities annually range from 1.13- 3.83 million³. Individuals most at risk for developing a Healthcare-Acquired Infection are those with chronic illnesses, immunocompromised, the very young and the elderly.

What’s Being Done About It
To curb the number of infections in the LTC setting the Center for Medicare and Medicaid Services (CMS) has mandated that facilities have at least one designated Infection Preventionist on staff. The role of the Infection Preventionist will be to oversee the development, monitoring and revision of the facility infection control program, infection surveillance, outbreak management, monitor antibiotic use, as well as employee infection control practices such as handwashing.

How You Can Help
The past 6 months of living with a pandemic have increased awareness of measures to control the spread of infection and disease. Basic infection control practices that are effective in controlling the spread of disease and infection should be incorporated into our daily routines, including:

• frequent hand hygiene (hand washing or hand sanitization when appropriate)
• use of personal protective equipment (masks, gowns or gloves)
• disinfection of frequently used surfaces
• maintaining safe distances for one another

How We Can Help You
Basic infection control measures require products such as hand soaps, hand sanitizers and surface disinfectants that will help prevent the spread of disease. It is important to choose products that are effective on a wide range of organisms, to minimize the transmission of disease.

DermaRite has a broad selection of infection control products to help you reduce the transmission of disease. You can explore the entire Infection Prevention & Control (IPAC) at dermarite.com/ipac.

References:

1. https://apic.org/monthly_alerts/who-are-infection-preventionists/
2. https://www.infectioncontroltoday.com/view/study-estimates-costs-hais
3. https://www.cdc.gov/nhsn/pdfs/training/2019/ltcf/infection-surv-ltc-508.pdf
4. https://www.cdc.gov/
5. https://www.provista.com/blog/blog-listing/infection-preventionist-mandate-for-ltc-takeseffect
6. https://www.sepsis.org/sepsisand/healthcare-acquiredinfections/#:~:text=Technically%2C%20any%20type%20of%20infection%20caught%20in%20a,di fficile%2C%20often%20called%20C.%20difficile%20or%20C.%20diff

Good hand hygiene, such as washing hands with warm soapy water, is one of the simplest, most effective ways to prevent illness and the spread of infection especially during cold and flu season. Hand washing is also a tool to help prevent the spread of COVID-19 commonly referred to as the Coronavirus.

When To Clean
The Centers for Disease Control (CDC) recommends the following handwashing guidance:
Wash hands –

• Before, during and after preparing food
• Before eating food
• Before and after caring for someone at home who is sick with vomiting and/or diarrhea
• Before and after treating a cut or wound
• After using the toilet
• After changing diapers or cleaning up a child who has used the toilet
• After blowing your nose, coughing or sneezing
• After handling pet food or pet treats
• After touching garbage or contaminated surfaces

How To Handwash
Handwashing is most effective when hands are wet thoroughly with water, adequate soap is applied and hands are rubbed together for 20 seconds. After washing, hands should be rinsed with water and dried with a disposable towel. Don’t forget to use the towel, not your clean hands to turn off the faucet.¹

What If Soap Is Not Available?
Unfortunately, soap and water are not always available to clean your hands. In those instances, using an alcohol-based hand sanitizer can be an effective substitute for handwashing.⁵ An alcohol-based hand sanitizer should contain at least 60% alcohol to be effective in reducing microbes (germs) on your hands.⁵ It’s important to note that hand sanitizers reduce, but do not eliminate all types of germs. Hand sanitizers are most effective when no visible dirt, grease, heavy soilage, or mucous is present on the skin.

How To Effectively Use Sanitizers
To use hand sanitizers effectively:

• Select a hand sanitizer that contains 60% alcohol or more.
• Cover the hands with enough sanitizer (refer to the product label for the amount to use).
• Rub your hands with the product until your hands are dry.²

Hand sanitizers should be kept out of the reach of children and used under adult supervision. Often products are scented or brightly colored and can be attractive to children.² Swallowing the product can be harmful, especially to young children.

Maintain Healthy Skin
An important, often overlooked part of hand hygiene is keeping the skin on our hands in good condition. Excessive handwashing can cause red, cracked, dry, even painful skin.³ Many soaps remove the natural oils that protect the skin. Use a pH balanced hand cleanser and a quality moisturizer frequently during the day to help to minimize the drying effects of frequent hand washing on the skin.

DermaRite is leading the way in skin care with products that can be used as part of a program to prevent the spread of infection as well as maintaining overall skin health.

CLEAN – DermaKleen™

DermaKleen is a gentle, Triclosan-free, pH balanced antimicrobial hand cleanser, enriched with vitamin E. DermaKleen hand soap is mild on skin. Softens, conditions and moisturizes hands. Active against: Gram Positive Bacteria and Gram Negative Bacteria. Contains chloroxylenol.

SANITIZE – GelRite®
GelRite is an alcohol-based, pH balanced instant hand sanitizer. Kills 99% of germs. Enriched with vitamin E to keep hands soft even after repeated use. Won’t leave a sticky or tacky residue. No rinse.

SANITIZE – San-E-Foam™
San-E-Foam is an alcohol-based, pH balanced foaming hand sanitizer. Soothing, rich foam lather leave hands soft even after repeated use. For use as a health care personnel hand wash, with fast acting, broad spectrum antimicrobial activity. No sticky or tacky residue. No rinse.

MOISTURIZE & PROTECT – Renew™ Skin Repair Cream
Renew Skin Repair Cream was designed to provide maximum skin hydration while still being light enough for everyday use. Protects and helps relieve dry, chapped or cracked skin, and restores moisture. Contains dimethicone, aloe vera, and natural and essential oils combined to form a moisturizing barrier that nourishes and rejuvenates the skin.

References:

1. https://www.cdc.gov/handhygiene/patients/index.html
2. https://www.cdc.gov/handwashing/show-me-the-science-hand-sanitizer.html
3. Graedon, J. (2019, September 4). How to Deal with Dry Skin and Cracks from Too Much Hand Washing. Retrieved from https://www.peoplespharmacy.com/articles/how-to-deal-with-dry-skin-and-cracks-from-too-much-hand-washing
4. https://www.piedmont.org/living-better/too-much-hand-washing-can-make-you-sick
5. https://www.cdc.gov/coronavirus/2019-ncov/about/transmission.html