LAUSR

BACKGROUND Non-antiseptic bathing practices among inpatients and residents of nursing homes vary in terms of frequency, bathing type and product. We performed a systematic review to compare the efficacy of different bathing practices in reducing skin colonization, healthcare-associated infections (HAI) or their impact on skin integrity. METHODS We searched Medline and Embase up until February 2018 testing a combination of terms for three concepts: 1) personal hygiene 2) inpatients 3) skin colonization, integrity or healthcare-associated infections. Studies set in ICUs or including children were excluded. This review was registered in PROSPERO: CRD42018091639. RESULTS Seven studies were included. No statistically significant impact in terms of reduced skin colonization was described irrespective of bathing product, type or frequency except for a reduced burden of C. difficile on the skin of infected patients after showering compared to bathing. One study addressing impact on HAI did not detect a significant difference when a waterless no-rinse product was used. Integrity of the skin was better preserved by no-rinse products. CONCLUSIONS No study described a statistically significant reduction of bacterial skin colonization or incidence of HAI after bathing hospitalized patients with non-antiseptic products. However, waterless no-rinse products were associated with less skin damage in most studies.