Slotosch Caroline M, Kampf Günter, Löffler Harald
Department of Dermatology, Philipp-University, Marburg, Germany.
Contact Dermatitis. 2007 Oct;57(4):235-41. doi: 10.1111/j.1600-0536.2007.01200.x.
We investigated the biological response of regular human skin to alcohol-based disinfectants and detergents in a repetitive test design. Using non-invasive diagnostic tools such as transepidermal water loss, laser-Doppler flowmetry and corneometry, we quantified the irritative effects of a propanol-based hand disinfectant (Sterillium), its propanol mixture (2-propanol 45% w/w and 1-propanol 30% w/w), sodium lauryl sulfate (SLS) 0.5% and distilled water. The substances were applied in a 2-D patch test in a repetitive occlusive test design to the back. Additionally, we performed a wash test on the forearms that was supposed to mimic the skin affection in the normal daily routine of health care workers. In this controlled half-side test design, we included the single application of the hand rub, SLS 0.5% and water as well as a tandem application of the same substances. Patch test and wash test showed similar results. The alcohol-based test preparations showed minimal irritation rather comparable to the application of water. However, the detergent SLS produced stronger barrier disruption, erythema and dryness than the alcohol-based preparations. There was no additional irritation at the combined use of SLS and disinfectants. By contrary, there was even a decrease in barrier disruption and erythema induced by the tandem application of SLS followed by alcohol-based disinfection compared with the use of SLS alone. These findings show a less irritant effect of alcohol-based disinfectants on the skin than detergents. Our study shows that there is no summation of irritating effects of a common detergent and propanol and that the combination of washing and disinfection has a rather protective aspect compared with washing alone.
我们在重复试验设计中研究了正常人体皮肤对酒精类消毒剂和洗涤剂的生物反应。使用无创诊断工具，如经表皮水分流失、激光多普勒血流仪和角质层测厚仪，我们量化了基于丙醇的手部消毒剂（施德力）、其丙醇混合物（2-丙醇45% w/w和1-丙醇30% w/w）、0.5%月桂醇硫酸酯钠（SLS）和蒸馏水的刺激作用。这些物质以二维贴片试验的形式，采用重复封闭试验设计涂抹于背部。此外，我们在前臂进行了一项洗涤试验，该试验旨在模拟医护人员日常工作中皮肤受到的影响。在这种对照半侧试验设计中，我们纳入了手部揉搓剂、0.5% SLS和水的单次应用，以及相同物质的串联应用。贴片试验和洗涤试验结果相似。酒精类试验制剂显示出最小的刺激性，与用水涂抹相当。然而，洗涤剂SLS比酒精类制剂产生更强的屏障破坏、红斑和干燥。SLS与消毒剂联合使用时没有额外的刺激。相反，与单独使用SLS相比，SLS后接酒精类消毒的串联应用导致的屏障破坏和红斑甚至有所减少。这些发现表明，酒精类消毒剂对皮肤的刺激性比洗涤剂小。我们的研究表明，常见洗涤剂和丙醇的刺激作用不会叠加，与单独洗涤相比，洗涤和消毒的联合应用具有相当的保护作用。
