Background: Hand hygiene is one of the most effective procedures for preventing health care-associated infection. Barrier creams are used to prevent the irritant effect caused by occupational exposure.

Objective: To compare an aluminum chlorohydrate-containing hand cream and a conventional cream in health-care workers (HCWs) by using clinical assessment score and quantitative measurement of transepidermal water loss (TEWL).

Materials and Methods: A double-blinded, randomized, placebo-controlled trial was performed in pediatric intensive care unit HCWs. The subjects were assigned to regularly use the given cream (one fingertip unit per time, equal to 0.5 gram) after washing their hands with either 4% chlorhexidine gluconate or alcohol hand rub, which is 70% alcohol, glycerin, D-panthenol. The clinical assessment score, ranging from 0 to 3 points per item, were performed by the investigator evaluating for erythema, dryness, scaling, vesicles, fissuring and lichenification, and by the subject evaluating the redness, itching, tightness, dryness and sweating, together with TEWL assessment in a controlled environmental condition at day 0, 7, and 14.

Results: Sixty HCWs were equally divided for each product. Barrier cream and conventional cream, amount used were 32.20 g and 26.43 g, respectively. At day 14, the clinical assessment score by the investigator and by the subject were reduced by 40.02% and 43.38% in the barrier cream group, and 35.5% and 47.83% in the conventional cream group (p<0.001. However, the TEWL in both groups was not significantly different from the baseline. Both products were well tolerated.

Conclusion: The amount of cream applied by HCWs was lower than assigned. Both barrier cream and conventional cream can clinically improve the clinical score. Frequent and regular use of hand creams should be encouraged to decrease or prevent skin irritation and hand dermatitis.

Keywords: Protective hand cream, Transepidermal water loss, Healthcare workers, Hand hygiene practices, Pediatric intensive care unit

DOI: doi.org/10.35755/jmedassocthai.2021.01.11546

Received 15 June 2020 | Revised 24 August 2020 | Accepted 25 August 2020