Disposable vs Microfiber reusable wipes

 

The debate between Infection Prevention & Environmental support services.

 

Filed under
Infection Control
 
May 8, 2023
 
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Disposable vs Microfiber reusable wipes
 

Cleaning and disinfection are two distinct processes carried out by two differently orientated stakeholders focussing on the single outcome of patient safety.  

For clinical staff, the convenience of a pre-dosed wipe available at point of use is ideal. However is this practice universally acceptable in terms of cleaning standards, disinfection efficacy, what is the effective coverage?, Is a single use disposable wipe a sustainable practice? 

For Environmental support services there is a choice of cleaning materials, including non-woven disposable janitorial cloths, disposable microfiber wipes, launderable microfibre and cloths made from plant based materials such as cellulose and bamboo. What are the sustainability credentials for each of these materials?

The starting point of the debate must be about performance. There is a standard for Disinfection with mechanical action EN 16615. This is a four-field test which measures removal of contamination from an inoculated site using a machine to replicate a manual wiping action. The test also measures three additional sites to validate that there has been no spread of contamination across the test surfaces.

Do all disposable wipes perform equally?  The answer is NO. It depends on the chemical formulation, the substrate used and the liquid release characteristics which can vary the effective coverage area and chemical action of contact time, prior to drying. What are the chemicals used? Bactericidal, sporicidal, virucidal, Fungicidal or a broad-spectrum Universal formulation. These chemicals when dry can leave a residue which may inhibit decontamination of biofilms and soil residue.

Microfibre textiles have unique physical properties which combine mechanical action, and physical forces of capillary action and adsorption removing contamination from the surface. In effect the surface is being cleaned and decontaminated simultaneously without the need for chemicals. The EN16615 Disinfection test for microfibre is the same standard test but using water alone.

Point 1. Microfibre can reduce or eliminate the use of chemicals.

Point 2. Microfibre uses mechanical action to penetrate surface soil including dry biofilm on surfaces.

Point 3. Microfibre fibres conform to the three dimensional surface profile of texture or surface damage where contamination may be harboured. Some equipment surfaces may have a manufacturer's  antimicrobial finish  within the material or applied as a coating. To provide an antimicrobial effect the surface soil must be effectively removed at each cleaning cycle.

Point 4. Professional Microfibre cleaning cloths can be laundered several hundred times and remain effective throughout its life cycle.  The microfibre textile can be processed and repurposed. 

Point 5. Microfibre textiles can be tested and validated for microplastic loss and environmental impact. The Nordic Swan Ecolabel validation measures environmental impact of production, consumption in practical use and is a certification awarded to those manufacturers who meet the Nordic Swan environmental standards.

From a practical perspective for Environmental Support Services, microfibre textiles provide a reliable tool in maintaining high hygiene standards. Cross contamination from surfaces to hands and hands to surfaces is the primary route of infection. Removal of soil leaving surfaces clean, free from contamination and dry inhibits microbial colonisation between cleaning cycles. 

Environmental research has alerted us to emerging challenges associated with biofilms and its potential link with antimicrobial resistance. It is therefore critically important to reevaluate our decontamination strategy.

A biofilm is the protective structure formed around bacteria when adhering to and colonising a surface. The colonisation produces an extracellular polysaccharide matrix which adheres to the surface and provides a protective coating to the bacteria colony as it develops. 

The role of biofilms in antimicrobial resistance is the subject of ongoing research. Early investigation has illustrated a pattern of resistance in multiple microorganisms which appear to be susceptible to antibiotics when tested in aqueous solution but the same microorganisms become highly resistant when tested from a biofilm.

Effective manual cleaning is at the front line of prevention of biofilm formation and microbial surface contamination. 

Microfibre cleaning provides the option for effective removal by mechanical action from the patient surface and transfers the decontamination process from the open patient environment to a controlled and verifiable laundry process.

Disposable VS reusable is a complex debate with multiple factors depending on roles and responsibilities within the patient care environment. It is clear that the microbial challenges  of Healthcare Environment Hygiene are increasing with the impact of antimicrobial resistance.  At the same time we do need to assess environmental impact and sustainability for the planet and revise our perspective on some current practices, including current IPC guidance for environmental hygiene.


About the author:
Michael Rollins is an independent consultant specialising in the implementation of healthcare hygiene technology, environmental Infection prevention and integration with patient safety quality improvement initiatives. He is an active member of the Infection Prevention Society UK, Patron of the National Association of Healthcare Cleaning Professionals (AHCP) UK and member of the Education and Training advisory group. Michael is also an Associate Subject Matter Specialist (Environmental Infection Prevention) for Nahdat al Tamayuz, Abu Dhabi, and Environmental Education Excellence Ltd, Training company UK.