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Protocol of use - surfaces with alcohol

Surface disinfection is a key step in preventing healthcare-associated infections, particularly in dental clinics and surgical rooms dedicated to implantology. Among the most widely used disinfectants, alcohol—especially in the form of ethyl alcohol (ethanol) or isopropyl alcohol—is highly valued for its rapid effectiveness. However, its use requires precise knowledge of its properties, limitations, and official recommendations to ensure optimal disinfection.

1. Properties and Spectrum of Action of Alcohol

Alcohol primarily acts by denaturing proteins, leading to the destruction of cell membranes and lysis of microorganisms. Its spectrum of activity is broad but not complete:

Effective against: vegetative bacteria, mycobacteria (including Mycobacterium tuberculosis), enveloped viruses (e.g., HIV, HBV, HCV), fungi.

Poorly or not effective against: bacterial spores (e.g., Clostridium difficile), some non-enveloped viruses (e.g., norovirus).

Maximum effectiveness is achieved at concentrations between 60% and 80%. Below 50%, alcohol's efficacy drops significantly. Adding water enhances penetration into cell membranes, which is why 70% alcohol is more effective than 95% alcohol.

2. Recommended Indications for Alcohol

According to recommendations from the ANSM and CDC, alcohol is indicated for the disinfection of:

Small, clean, non-porous surfaces: countertops, dental units, non-critical medical devices.

Areas with low to moderate contamination risk, outside of final cleaning protocols.

Alcohol should not be used:

On visibly soiled surfaces (blood, saliva, organic material) without prior cleaning,

On large surfaces, as rapid evaporation limits contact time,

On sensitive materials (plastics, rubber, screens) which it may damage.

3. Conditions for Use and Precautions

To ensure effective disinfection:

Clean surfaces beforehand if visibly soiled,

Use an alcohol-based solution between 60% and 80%, ideally ready-to-use,

Respect a minimum contact time of 30 seconds to 1 minute, without immediate wiping,

Wear protective gloves during application,

Never mix alcohol with other chemicals (e.g., bleach) due to the risk of dangerous reactions,

Alcohol is flammable: storage and use must comply with strict safety instructions (sealed containers, keep away from heat sources).

4. Limitations of Alcohol in Disinfection

Despite its popularity, alcohol is not a universal solution. It does not provide:

Sporicidal activity,

Residual (long-term) action,

Sufficient effectiveness against biofilms.

In implant surgery contexts, alcohol is often used in combination with broader-spectrum disinfectants (e.g., glutaraldehyde, hydrogen peroxide, quaternary ammonium compounds), depending on the surface and level of risk.