Here's an evaluation of alcohol versus surfactant, allantoin, and benzalkonium chloride (SAB) hand sanitizers from the Association of periOperative Registered Nurses.
http://www.findarticles.com/cf_dls/m0FSL/n2_v68/21038187/p1/article.jhtml?term=
From the discussion of the results:
"After a single application, the alcohol-free SAB sanitizer and both alcohol-based formulas reduced bacteria more than a control nonantimicrobial handwash formula. When the protocol was repeated omitting the water rinse, similar results were achieved. This illustrated that the first time either of these types of products is used on any given day, degerming activity results that exceeds the federal requirements for antiseptic hand washes.
To be of any value in a health care setting, however, a hand antiseptic should give persistent antimicrobial activity with repeated use. Accordingly, the alcohol-free SAB sanitizer, with or without the water rinse, produced increased antimicrobial effectiveness over time with no adverse effects. In contrast to this, repeated use of the alcohol-based sanitizers produced a decrease in antimicrobial effectiveness over time and was accompanied by swelling, erythema, and discomfort of the palmar surface of subjects' hands. Importantly, by the completion of both the rinsing and nonrinsing protocols, antimicrobial persistence of the SAB formula was so pronounced that its performance exceeded federal requirements for antiseptic hand washes by at least 50%. The tested alcohol-based hand sanitizers, however, failed to meet this federal standard in both the rinse and nonrinse protocols.
In summary, the study showed
* the SAB hand sanitizer formula had a greater sustained degerming activity than the alcohol-containing hand sanitizer formula,
* the alcohol-containing hand sanitizer became less effective with repeated use and irritated the hands of subjects, and
* the SAB hand sanitizer formula became more effective without irritation after repeated use."
"The point for clinical education that may be gained from this study is that, although alcohol-based instant hand sanitizers are widely used in professional and nonprofessional circles, alcohol also is an effective organic solvent. As such, it readily strips away the natural chemical components of the skin (eg, sebum, lipids) that impede water loss and bacterial infection. Frequent and prolonged use of alcohol-containing hand sanitizer products, therefore, can be counterproductive to hand sanitization and can damage the skin."
