Antiseptic Handwash

Povidone iodine, 5 to 10% formulations, is considered safe and effective for use in antiseptic handwash.15 Povidone iodine is an iodophor composed of elemental iodine, iodide or triiodide, and a polymer carrier. The amount of free iodine determines its level of antimicrobial activity.16 Iodine molecules rapidly penetrate the microbial cell wall resulting in impaired protein synthesis and disruption of cell membrane. The extent of persistent antimicrobial activity is unclear.2

Antiseptic handwash (Figure 1) removes or destroys transient microorganisms and reduces the resident hand flora.2 It is an acceptable alternative to handwashing when the hands are visibly soiled. However, when the hands are not visibly soiled, an alcohol-based hand rub (Figure 2) is recommended.2,13,15 The concomitant use of an alcohol-based hand rub and povidone iodine is contraindicated and the use of antimicrobial-impregnated wipes (i.e., towelettes) are not acceptable for antiseptic handwash.

Figure 2. How to Hand rub when Hands are not Visibly Soiled?
Chart showing proper procedure for using hand rub on non-visibly soiled hands

How to Hand rub?


Duration of the entire procedure: 20-30 seconds

  1. 1a & 1b Apply a palmful of the product in a cupped hand, covering all surfaces;
  2. Rub hands palm to palm;
  3. Right palm over left dorsum with interlaced fingers and vice versa;
  4. Palm to palm with fingers interlaced;
  5. Backs of fingers to opposing palms with fingers interlocked;
  6. Rotational rubbing of left thumb clasped in right palm and vice versa;
  7. Rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm and vice versa;
  8. Once dry, your hands are safe.

Patient Safety A World Alliance for Safer Health Care

SAVE LIVES Clean Your Hands

All reasonable precautions have been taken by the World Health Organization to verify the information contained in this document. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use.

WHO acknowledges the Hôpitaux Universitaires de Genève (HUG), in particular the members of the Infection Control Programme, for their active participation in developing this material.

May 2009

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