Gundermann K O
Zentralbl Bakteriol Mikrobiol Hyg B Umwelthyg Krankenhaushyg Arbeitshyg Prav Med. 1986 Dec;183(2-3):196-203.
Disinfection of hands, skin or mucous membranes or the mere cleansing of hands have different functions, which should be differentiated clearly. With different cleansing methods dirt will be removed, whereas disinfection methods will eliminate microbial contamination or reduce the resident skin flora. Cleansing of hands removes only a very limited amount of microorganisms and cannot replace disinfection. Skin has to be disinfected when the integrity of the body is harmed. Depending on the tasks which are to be performed, sometimes an immediate onset of action and not a long duration of effect can be desirable. In other cases it is just the prolonged action, even with slow onset, that is required. Furthermore a long-lasting effect can be useful, when recontamination takes place later on. Skin disinfectants can be applied by spraying or swabbing. There are only limited data known over disinfection of mucous membranes and till now there exist no suitable test-methods. Experimental studies have shown no really convincing results, even though sometimes a sufficient disinfection could be seen in clinical practice. This is partly due to the bacteriostatic effect. The problematical nature of recontamination of mucous membranes is naturally very serious, but the adhesion of disinfectants due to the special conditions on mucous membranes usually rather bad. Which procedures have to be applied in particular cases has to be decided after weighting the risks against each other.
手部、皮肤或黏膜的消毒与单纯的手部清洁具有不同的功能，应予以明确区分。不同的清洁方法可去除污垢，而消毒方法则可消除微生物污染或减少皮肤常驻菌群。手部清洁只能去除极少量微生物，无法替代消毒。当身体完整性受到损害时，皮肤必须进行消毒。根据要执行的任务，有时可能需要立即起效而非长效作用。在其他情况下，则恰恰需要长效作用，即使起效缓慢。此外，当后续发生再次污染时，长效作用可能会很有用。皮肤消毒剂可通过喷雾或擦拭的方式使用。关于黏膜消毒的已知数据有限，目前尚无合适的测试方法。实验研究并未得出真正令人信服的结果，尽管在临床实践中有时可看到充分的消毒效果。这部分归因于抑菌作用。黏膜再次污染的问题本质上非常严重，但由于黏膜特殊条件导致消毒剂的附着力通常很差。在权衡相互风险后，必须决定在特定情况下应采用哪些程序。
