Гелевые кожные антисептики на основе сафлорового масла в профилактике внутрибольничных инфекций
Ключевые слова:
внутрибольничные инфекции, гигиена рук, кожные антисептики, сафлоровое масло, спиртосодержащие антисептики, барьерная функция кожи, эмоленты, профилактика инфекцийАннотация
Внутрибольничные инфекции остаются одной из ведущих причин заболеваемости и экономических потерь в системе здравоохранения, при этом контактный путь передачи через контаминированные руки медицинского персонала является основным механизмом их распространения. Кожная антисептика рук рассматривается как ключевой элемент программ инфекционного контроля, а эффективность применяемых средств определяется не только антимикробным спектром, но и кинетикой действия, остаточной активностью, лекарственной формой и переносимостью при многократном использовании.
Настоящая работа представляет собой нарративный обзор с элементами систематического поиска, посвящённый анализу современных данных о спиртосодержащих гелевых кожных антисептиках для обработки рук медицинского персонала в системе профилактики инфекций, связанных с оказанием медицинской помощи, с акцентом на комбинированные формуляции, содержащие катионные антисептики, органические кислоты и эмолентные компоненты. Обобщены результаты клинических и экспериментальных исследований, а также международных рекомендаций и стандартов, касающихся антимикробной и противовирусной активности, пролонгированного действия и дерматологической переносимости гелевых антисептиков.
Показано, что сочетание этанола с четвертичными аммониевыми соединениями и органическими кислотами обеспечивает синергетическое бактерицидное и вирулицидное действие в отношении основных возбудителей внутрибольничных инфекций и формирование остаточной антимикробной активности. Гелевая лекарственная форма способствует увеличению времени контакта активных веществ с кожей и оптимизации кинетики антисептического эффекта по сравнению с жидкими растворами.
На основании данных доказательной литературы обоснована роль эмолентных и липидовосполняющих компонентов в сохранении барьерных свойств кожи, профилактике сухости и раздражения, а также поддержании физиологического кислотно-щелочного баланса. Особое внимание уделено сафлоровому маслу как источнику линолевой кислоты и токоферолов, способствующих восстановлению липидного матрикса рогового слоя и снижению трансэпидермальной потери воды, что потенциально повышает переносимость антисептических средств и комплаенс медицинского персонала к процедурам гигиены рук.
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