Washing before gloving reduces the initial microbial levels, and washing after glove removal reduces the number of those that have multiplied under the gloves. Handwashing after glove removal is also important because it removes the microbes that may have contacted the skin through defects in the gloves. Another benefit of handwashing, at least when using handwashing products that contain antimicrobial agents, is that they have a prolonged effect that minimizes the number of microbes on the skin. They are also used by individuals who desire extra protection after routine handwashing. Most of the antiseptic waterless hand rubs contain some formulation of alcohol.
Alcohols have excellent bactericidal activity and act against many fungi and viruses.
Alcohols are not good cleaning agents though, and are not recommended for use in the presence of physical dirt. The major disadvantage of using alcohols for skin antisepsis is its drying effect. To prevent drying, most products add emollients. Emollients may enhance antibacterial activity by slowing drying, resulting in increased contact time of the alcohol. In summary, waterless antiseptic hand rubs should not be substituted for routine handwashing between patient visits because they have poor cleaning ability and are not recommended by their manufacturers for this purpose.