With a skin disorder such as EB where bleeding and draining wounds are common, it is crucial to reduce the risk of spreading infection from contact with dirty, contaminated dressings. In order to protect family members, friends and caregivers, and the person with EB, it is important to maintain standard contact precautions. These are guidelines designed by the CDC (U.S. Department of Health and Human Services, Center for Disease Control and Prevention) to reduce the risk of transmission of microorganisms in hospitals, but the principles apply to home situations, as well. At this time, infection control guidelines for the home setting have not been developed by the CDC.
Standard infection control precautions should be maintained when one comes in contact with:
- all body fluids, secretions and excretions except sweat, regardless of whether or not they contain visible blood
- non-intact skin
- mucous membranes
Contact precautions apply to individuals known or suspected to be infected or colonized (demonstrating the presence of bacteria, mold/yeast, or virus in or on the patient but without clinical signs and symptoms of infection) with microorganisms.
These precautions include guidelines about:
- Hand hygiene: the single, most effective way to minimize the spread of infection. Remember to wash your hands with soap or other cleanser and water or use an alcohol-based handrub before and after handling dressings.
- Alcohol-based handrubs: significantly reduce microorganisms on skin and are fast-acting. These may be used in place of soap or cleanser and water, but gloves should still be worn when handling dressings.
- Use of gloves (hand washing or use of alcohol-based handrubs is still essential).
- Handling soiled linen, clothing and bandages properly; must be done in a manner that prevents contamination and transfer of microorganisms. In general, you should perform hand hygiene before and after handling dressings, wear gloves while handling dressings, and dispose of soiled dressings directly into a dedicated "dirty dressing" bag or bin.
Other recommendations include:
- Use paper towels rather than fabric towels after hand washing, as towels can easily become contaminated.
- Avoid “double-dipping” in jars of ointment. Use of a clean wooden tongue-depressor or plastic spoon or knife may be used to remove ointment from the jar.
- Avoid using your fingers to directly remove ointments and medications from tubes. Squeeze the ointment or medication onto a clean wooden tongue-depressor or plastic spoon or knife to remove ointment or medication from the tube.
- Use a smock or gown to cover your clothing when working with bleeding or draining wounds.
- Clean and disinfect surfaces, keyboards, phones and remote controls regularly.
- Cleanse humidifiers daily using soap and water, then rinse with a diluted bleach solution (1:10).
- Clean the bandaging area, bathtub, and supplies such as bandage scissors with disinfectant. Disinfectants kill most bacteria and may kill mold, yeast and viruses. Disinfecting the bandage changing area will help prevent the spread of infection.
- Change you or your child’s toothbrush regularly, especially after the flu or a cold.
- Consider supplying “tools” for the child to take to school, i.e., his/her own crayons, markers, etc.