Surface Disinfectant Wipes: Part I
A Fit for Today's Asepsis Standards?
Nancy Andrews, RDH, BS
Environmental surface cleaning and disinfection is a fundamental aspect of accepted infection control practices, and has evolved along with many other strategies in clinical asepsis. The early use of 2 x 2 gauze squares moistened with alcohol, soap and water, or other solutions such as orange solvent transitioned to generalized spraying of rooms with liquid chemical cleaners and disinfectants and wiping with paper towels; significant strides were made to prevent cross-contamination. This evolution continues, as manufacturers perfect the concept of pre-saturated wipes that disinfect quickly and efficiently, and reduce some of the negative aspects of spray disinfectants.
Considerations for Pre-Saturated Surface Disinfectant Wipes:
- Wipes reduce workers’ exposure to aerosolized chemicals (potential irritants or toxins) when compared to spray disinfectants.
- The wipe material is presaturated, pliable, and instantly delivers the solution to the surface, spreads evenly, and without dripping.
- The absorbency of the wipe controls the amount of solution placed on a surface, and should meter the tested dose needed, while avoiding oversaturation and pooling of chemical solution.
- The disinfectant solution is tested for compatibility with the wipe and should remain stable in the presence of the wipe material.
- Current infection control recommendations and key thought leaders suggest using strategies and physical barriers to AVOID contamination during patient treatment. When barriers are changed between patients, only those exposed surfaces or areas where the barriers are compromised need to be cleaned and disinfected. Covered surfaces should be cleaned and disinfected at regular intervals (ie, twice per day). Presaturated wipes make “selective surface disinfection” easier, more effective, and less messy.
- Wipes avoid “over spray”--the familiar “shower” of spray that travels beyond the target. For example, when spraying the dental light handle, overspray is difficult to control and may spot or damage the light cover or upholstery.
- Wiping twice during both the first cleaning step and the second disinfecting step doubles the physical cleaning of a surface.
Two-Step Process--Clean, Then Disinfect
Cleaning is the necessary first step of disinfection and sterilization, as physical debris and bioburden are likely to interfere with the effectiveness of disinfectants. When using wipes, the first cleaning wipe must be saturated with a solution that cleans well, and should be chemically compatible with the second wipe to avoid damage to surfaces or potentially dangerous fumes. One prudent strategy is to select a product that may be used for both steps effectively. Alcohol—a common ingredient in surface disinfectants—quickly kills certain microbes, providing a rapid “tuberculosis (TB) kill time,” but has other properties that interfere with cleaning. Disinfectants with a high alcohol content (over approximately 23%) do not provide adequate cleaning and, therefore, should be used only for disinfection (step 2). Such products require a separate product with less than 23% alcohol for the cleaning step. Nonalcohol wipes tend to have longer TB kill times, and must remain on surfaces longer for effective disinfection, but avoid some of the negative effects of alcohol on surfaces and materials.
Presaturated disinfectant wipes streamline surface cleaning and disinfection. They are recommended in a combined protocol with aseptic technique, use of surface barriers, and disposable and/or autoclavable items to meet today’s clinical asepsis standards. Part 2 (http://staging.thenextdds.com/Articles/Surface-Wipe-Disinfectants--Part-II/) will discuss the criteria for surface disinfectant wipe selection.
*OSAP member and consultant in infection control
Organization for Safety & Asepsis Procedures: www.OSAP.org
Center for Disease Control: www.cdc.gov