Kramer A, Guggenbichler P, Heldt P, Jünger M, Ladwig A, Thierbach H, Weber U, Daeschlein G
Institute of Hygiene and Environmental Medicine, Ernst-Moritz Arndt University, Greifswald, Germany.
Curr Probl Dermatol. 2006;33:78-109. doi: 10.1159/000093938.
The antimicrobial impregnation of textiles is intended to provide protection of textiles against microbial corrosion, prevention of malodor or prophylaxis and therapy of infections, respectively. For every biocidal product a careful risk assessment for humans and the environment has to be performed. The advantage of antimicrobially active textiles has to be documented for every agent as well as for every application, and a balance has to be found between a textile's quality rating and the potential risks, e.g. sensitization, disturbance of the ecology of the skin, toxic side effects by means of systemic absorption, cytotoxicity, genotoxicity, carcinogenicity, teratogenicity and ecotoxicity. This article evaluates the applicability of silver compounds as well as the classic antimicrobials triclosan, quaternary ammonium compounds, copper and further new options like chitosan and zeolite. It has to be emphasized that there are no objections against the use of antimicrobially active textiles if their use is equal or superior to other preventive or therapeutic measures. This applies to the amelioration of the course of dermatological diseases with disturbed skin flora, in particular atopic dermatitis, the prevention and therapy of acute and chronic wound infections by wound dressings, the use of impregnated surgical suture material as well as special indications in the prevention of infection in medical facilities. The use of antimicrobial textiles for the prevention of dermatomycosis by antifungal impregnation is of questionable use; the antimicrobial impregnation of textiles for deodorization purposes has to be avoided. Presently, from a hygienic point of view, the following questions have to be clearly determined: declaration of any antimicrobial impregnation; development of international standards for in vitro testing and preclinical evaluation of efficacy and tolerance; evaluation of the advantage of the antimicrobial properties for the intended use including the risk-benefit assessment.
纺织品的抗菌浸渍旨在分别保护纺织品免受微生物腐蚀、防止产生恶臭或预防和治疗感染。对于每种生物杀灭产品，都必须对人类和环境进行仔细的风险评估。必须记录每种抗菌剂以及每种应用中具有抗菌活性纺织品的优势，并且必须在纺织品的质量评级与潜在风险之间找到平衡，例如致敏、皮肤生态紊乱、通过全身吸收产生的毒副作用、细胞毒性、遗传毒性、致癌性、致畸性和生态毒性。本文评估了银化合物以及经典抗菌剂三氯生、季铵化合物、铜以及壳聚糖和沸石等其他新选项的适用性。必须强调的是，如果抗菌活性纺织品的使用等同于或优于其他预防或治疗措施，则对其使用不存在异议。这适用于改善皮肤菌群紊乱的皮肤病病程，特别是特应性皮炎，通过伤口敷料预防和治疗急慢性伤口感染，使用浸渍的手术缝合材料以及在医疗设施中预防感染的特殊指征。通过抗真菌浸渍使用抗菌纺织品预防皮肤癣菌病的用途值得怀疑；必须避免为除臭目的而对纺织品进行抗菌浸渍。目前，从卫生角度来看，必须明确确定以下问题：任何抗菌浸渍的声明；制定体外测试以及疗效和耐受性临床前评估的国际标准；评估抗菌性能在预期用途中的优势，包括风险效益评估。
