Quaternary ammonium compounds: Use them – yes or no? Which ones?

Quaternary ammonium compounds (also known as QUATS especially Benzalkonium chloride, first generation QUATS) have long been relegated to the role of low level disinfectants with an incomplete spectrum as they do not act against certain pathogens such as Gram negatives Furthermore, the phenomena of toxicity and skin sensitisation have radically set the limits. Nowadays however, with the introduction of the new QUATS, the so-called 4th generation quaternary ammonium compounds (that introduce alterations to the basic structure of Benzalkonium chloride), compounds have been obtained that not only act against Grams – (Pseudomonas), but also deal with what were possible potential toxicological and sensitisation effects.

As heavy compounds at suitable concentrations, the phenomenon of volatility is avoided thus making them also suitable for use in narrow spaces with poor ventilation. It is obvious that by themselves, they will never have a sufficient spectrum to kill a viral load but, when used in association (taking advantage of the “principle of synergy”) nowadays form highly effective, safe and practical compounds.

Enzymatic systems: What are they and what do they do?

The so-called multi-enzymatic systems, also known as proteolytic systems (i.e. capable of breaking down proteins) should be selective, stable systems that can keep their enzymatic properties unaltered throughout the course of the working day.

These protease, lipase and amylase enzymes (the only three enzymes that really should be in a product) have to be tested to demonstrate their selectivity and stability over time. Thanks to these specific tests, users can rest assured regarding the safety of the product they have bought. This enzymatic system stability should also be tested for the ultrasound bath that is used very frequently to cut down decontamination – cleaning times but that can harm the product used.


Surgical scrubbing gel or antiseptic soap?

Given that hand washing is expensive, time-consuming and that it can often lead to dry and irritated skin, experts have devised new strategies to increase the level of compliance with hand hygiene indications for staff.

With the intention of making antisepsis of the hands easier, faster and more efficient and of involving less force and therefore creating less irritation, the new OMS guidelines allow for the use of hydroalcoholic based solutions or gels to replace the traditional chlorohexidine or iodine based soaps. Various studies have demonstrated that nursing staff who use alcoholic products for antisepsis of the hands and who are supplied with suitable emollients and moisturisers, have suffered less dry and irritated skin than others who have used just soap and water. It should be noted that gels have proven to be the most practical application as they spread more evenly over the hands. This is particularly true for the latest generation of thixotropic gels that allow for even very short contact times (e.g.: they can meet EN 14791 requirements in 1 min and 30 seconds instead of in 3 min in total), this further improving compliance and cost benefits.

Questo è soprattutto vero per i gel di ultima generazione, di tipo tissotropico, che riescono quindi ad avere tempi di contatto più brevi (ad es: possono soddisfare la norma EN 14791 in 1 min e 30 totale anziché 3 min totali), migliorando ulteriormente compliance e costi di utilizzo per la struttura.