Hand-hygiene method should reflect the condition of the hands. When dirt, blood, body fluid or other visible material is present, physical removal becomes important.
Visible soil is more than a cosmetic issue
Soil can include dirt, grease, organic material and contamination picked up during work. It can cover parts of the skin and make waterless hand sanitising less suitable.
Soap and water provides physical removal
Washing uses soap, water, rubbing and rinsing to loosen and carry visible material away from the hands. CDC requires soap and water when healthcare personnel's hands are visibly soiled.
Sanitiser does not rinse contamination away
Alcohol-based hand sanitizer can inactivate many microorganisms, but it does not physically rinse off visible dirt, heavy grease or all contaminants.
Healthcare guidance is setting-specific
In most clinical situations where hands are not visibly soiled, CDC prefers alcohol-based hand sanitizer. Visible soiling changes that choice to soap and water.
Do not add steps without a reason
Routine practice does not require automatically applying sanitizer after every soap-and-water wash. Follow the facility's hand-hygiene procedure and the clinical indication.
Gloves do not change the basic rule
Gloves can become contaminated and do not replace hand hygiene. Clean hands at the required moments, including after glove removal.
Practical takeaway
If hands are visibly soiled, choose soap and water for physical removal. If they are not visibly soiled, the preferred method depends on the setting and applicable hand-hygiene guidance.
