home › Health › The role of personal hygiene and hygiene procedures in the lives of special children and young people with disabilities.

The role of personal hygiene and hygiene procedures in the lives of special children and young people with disabilities.

- This is a set of procedures that are aimed at improving the teeth and gums, preventing the development of pathologies in the oral cavity.

During the cleaning process, the doctor completely removes plaque from the enamel, brightens it, as a result of which the unpleasant odor disappears and the oral cavity is completely healed.

The desire to have a snow-white and healthy smile pushes people to go to the dentist-hygienist. What is this procedure, how does it work and how often can you clean it?

Dentists say that even the highest quality oral care products are not able to completely clean the enamel from unpleasant plaque.

Even with the most thorough cleaning, the brush is not able to clean the gap between the teeth or the subgingival space.

So, with home hygiene procedures, only 60% of contaminants are removed from the coating, and everything else accumulates and becomes a good environment for inflammation.

In addition, all these accumulations harden over time and become a stone that has an ugly color.

Based on the foregoing, there are several reasons why you should contact a hygienist for cleaning.

The procedure will help protect the patient from the further development of caries and other diseases of the oral cavity.

Thus, after cleaning, you will have to visit the dentist much less frequently. In addition, the cost of the procedure is noticeably lower than the treatment, which is also a big plus.

After the procedure, the teeth will become brighter, and the smile will look well-groomed and brighter.

Often, after cleaning, bleaching is not even required, since the enamel cleaned from plaque already looks natural and beautiful.

Doctors advise cleaning before starting treatment.

First of all, cleaning will be useful for the general condition of the gums, which is especially important when filling.

Secondly, on clean teeth it will be easier for the doctor to detect the affected areas. After cleaning, the doctor will be able to better choose the shade of the filling, in addition, the filling will last much longer.

Some patients think that after hygienic cleaning you can forget about problems with your teeth for a long time.

However, it is important to understand that bacteria in the oral cavity are constantly present, and the fight against them also does not stop.

Therefore, doctors advise visiting a hygienist every six months, and between these sessions, you need to carefully monitor your teeth and the condition of the whole organism.

How is the cleaning going?

Not so long ago, the only way to clean teeth from plaque was mechanical cleaning of the enamel with special tools.

All this lasted for a long time, besides, the coating was amenable to significant mechanical stress.

Fortunately, medicine does not stand still, and today there are many other ways.

Most often, doctors suggest cleaning them with hardware methods. Comprehensive cleaning is done in several stages.

First of all, which is destroyed under the influence of microvibration.

During this, the pressure of water also affects the enamel, which cools the teeth, helps to reduce discomfort and improves the removal of the stone from the enamel.

This procedure practically does not cause pain and other sensations, but if the patient suffers from hypersensitivity, the doctor may suggest introducing local anesthesia.

After all the stones are removed, the doctor cleans the enamel from plaque from soft particles using the force of the air stream.

An aerosol consisting of water and soda is fed from a special apparatus. It removes plaque and pigmented areas, slightly polishes the coating of the entire tooth.

As a result of such exposure, the enamel becomes smooth, acquires its natural color, without yellow and brown blotches.

It is important to understand that sandblasting will not be a complete replacement for ultrasonic cleaning, as it does not remove stone, but only soft particles.

The next step in cleaning is polishing the surface of the tooth. This is done using a special paste.

The composition is chosen for each patient individually, taking into account all the features of the oral cavity.

Even with small fillings, polishing will make the tooth smooth and shiny.

Due to the smoothness of the enamel, plaque can no longer form, which means that caries and other problems of the oral cavity do not threaten the patient.

The hygienic cleaning of the teeth ends with the application of fluorine varnish, which strengthens the enamel and is a prevention of hypersensitivity after the cleaning procedure.

Fluorine suppresses the negative impact of the acidic environment on tooth enamel, prevents the development of bacteria that destroy the coating of the tooth and cause caries.

Fluoridation can be simple and deep - only a doctor chooses a method for treating teeth, based on the age of the patient, the condition of the teeth, and much more.

With simple fluoridation, the substance is applied to the teeth with a brush and slightly dried with an air stream.

This varnish, like a film, envelops the tooth and remains on its surface for several days.

According to expert reviews, modern domestic fluoride varnishes can make teeth yellow, so it is important to use only high-quality materials.

The greatest effect of fluoridation can be achieved after 3-4 procedures.

Inside, they are filled with fluoride gel and put on the teeth for about 4 minutes.

To achieve the best result, the doctor may recommend that the patient use home hygiene products.

In recent years, fluoridation has become very popular in dentistry.

Both methods described above help to enrich the tooth enamel with fluoride, while they are absolutely safe and do not cause discomfort.

However, to get calcium fluoride into the deep layers of the dental coating, only deep fluoridation should be used.

For deep fluoridation, doctors apply enamel-sealing liquid.

Under the action of the composition, particles of calcium, magnesium and copper are deposited in the dentinal tubules, which remain there for about a year and improve the quality of the enamel.

Such cleaning is prescribed to prevent the formation of caries, close the enamel after removing the stone, and treat caries in the early stages.

First, the teeth are treated with a fluoride composition, wait a couple of minutes and dry with an air stream.

To achieve the maximum effect from such a procedure, you need to repeat it three times, every 1-2 weeks.

Such cleaning is completely safe and can be prescribed even for children.

Who needs a procedure?

Many people have a question: to whom and how often can you clean the enamel?

Doctors advise patients to perform hygienic cleaning a couple of times a year, and in special cases more procedures will be required.

According to the reviews of doctors, professional hygienic cleaning of teeth helps to prevent many diseases of the oral cavity.

Such cleaning is simply necessary for restorations (crowns, veneers), since all these structures need to be looked after in a special way.

Despite the fact that hygienic teeth cleaning is absolutely safe and technologically advanced, it is still not possible to carry it out in all cases.

Contraindications for the use of ultrasound techniques are heart problems, arrhythmias, respiratory pathologies, excessive enamel sensitivity, very severe gum inflammation, childhood and adolescence.

If the patient has contraindications to ultrasonic procedures, then the doctor cleans the teeth from deposits with the help of hand tools and a special paste, using special nozzles for a drill.

Some patients who underwent hygienic cleaning were dissatisfied with this procedure.

Sometimes the result of cleaning is excessive sensitivity, cracks in the coating, inflammatory damage to the gums, loss of fillings and much more.

However, the cause of such troubles is not the hygienic brushing itself, but rather its unprofessional performance.

In each individual case, the doctor needs to decide how often to clean, which is why it is so important to find a specialist who will use an individual approach in their work.

Special attention. And this is more than justified. Even a little negligence in this matter can cause serious problems that cannot be called "children's".

In fact, hygiene procedures are a routine procedure that is repeated several times throughout the day. Therefore, once having mastered the basic rules for their implementation, you can not worry about the cleanliness and safety of the child in the future.

Hygiene procedures must be carried out every time after emptying the intestines of the child. In addition, a daily evening is mandatory. It will not be superfluous to wash the child when changing diapers.

Despite the amazing abundance of hygiene products, ordinary running water is still considered an ideal option for hygiene procedures. An important point is the preliminary thorough treatment of the hands of an adult (the use of soap is mandatory).

For heavily soiled baby skin, you can use a small amount of baby bath or baby soap.

Features of hygiene procedures "by gender"

There is one feature in that. When washing girls, they should be held in such a way that the direction of the flow of water is from the genitals towards the anus, and not vice versa. The hand of an adult should follow the same trajectory - from the external genitalia backwards. It is very important to wash the fold located between the small and large labia well at least once a day - this is where the secret most often accumulates.

Despite the simplicity of air baths, they give an excellent effect and it is unacceptable to neglect them when changing diapers!

And one more note regarding the storage of diapers. It is unacceptable to store them in rooms that are characterized by high humidity (in the kitchen or bathroom).

The basic rule for choosing a disposable diaper

It is very important that the disposable diaper is comfortable for the baby. These hygiene products are selected depending on the weight of the child. To make sure that the diaper is suitable for the baby, you should check how tightly it wraps around his tummy. If an adult's index finger can pass between them without much effort, then the size of the diaper corresponds to the weight of this baby.

Newborn Skin Care

After carrying out hygiene procedures, the child is wrapped in a towel and his skin is gently blotted. If there is no newborn on the skin, hygiene products are applied only after evening bathing once a day.

When the first pathological signs appear on the baby's skin, you should immediately contact your doctor and strictly observe the frequency of application of prescribed medicinal or preventive hygiene products.

Several important rules will allow prevent the occurrence of rashes:

the baby should always be dressed in accordance with;
children's bed linen should be washed separately from adult linen and it is advisable to set the extra rinse mode;
overdrying of children's skin with various hygiene products and soaps should not be allowed.

By following these simple rules, you can achieve perfectly delicate velvety skin of a child.

Crib for moms

Wash your baby after every bowel movement.

Be sure to bathe your child once a day.

It is advisable to wash the baby when changing diapers.

It is better to wash under running water.

Girls first wash the external genitalia, and then the anus.

Diapers are changed 4-6 times a day.

Every time you change a diaper, let your skin "breathe".

Proper skin care is primarily about keeping it clean. To do this, regularly wash the entire skin with soap and water at least once a week. Depending on the contamination of the skin, washing can be done even every day.

When washing the body with soap and water, the skin is cleansed of sebum and sweat, dust and dirt, various substances that a person comes into contact with at work, microbes that have fallen on the skin - pathogens, and finally, horny ones that have not yet fallen off the skin surface. scales. Under the influence of warm, and especially hot water, the sweat glands begin to work intensively, with sweat, metabolic products - slags - are removed from the body. Under the influence of water and rubbing, blood circulation in the skin increases, its tissue, nerves, glands and hair are better and more abundantly washed with blood and nourished. There is an increase in metabolism in the body, which contributes to health. This improves both the condition of the skin and its appearance.

Water temperature for water procedures. For water procedures use both warm and cold water. Cold refers to water at room temperature or slightly lower. To keep the skin clean, warm or even slightly hot water should be used, which washes away dirt better and cleanses the skin. Cold water in the form of cold baths, washings and rubdowns is used to strengthen the body and harden and keep the skin in a healthy, fresh state.

Hygiene procedures with cold water. Cold water procedures are supposed to be taken in such a state when a person feels slightly warm. Water should be at room temperature or slightly colder. The procedure lasts from a few seconds to one minute. After that, they vigorously rub the whole body with a dry towel until a pleasant warmth is felt, then quickly dress and make moderate movements. Cold water procedures can be taken only by those people who tolerate them well - after which redness of the skin quickly sets in, a feeling of pleasant warmth and good health. If, after taking such a procedure, the skin turns pale and turns blue, and the person is slightly chilled, then you should refrain from cold water procedures or take them carefully.

bathing. It is very useful to swim in the sea or in the river, while health is strengthened, the body is tempered and the skin is maintained in good cosmetic terms. Bathing in the open air is very useful, since the action of water is joined by the influence of sunlight and fresh clean air.

It should be remembered that with regular use of cold water, some people's skin becomes dry and hard.

Water quality. Soft water should be used for washing, washing and other hygiene procedures. This water does not contain lime and magnesium salts and does not irritate the skin. Soft water is rain, snow, partly river water. When using such water, the soap is easily lathered, which leads to a good cleansing of the skin.

Water that contains lime and magnesium salts is hard. From washing with such water, the skin becomes dense, dry, rough and ugly. Prolonged use of hard water can lead to skin irritation, especially for people who have dry, thin skin on their face. Therefore, hard water should not be used for hygiene procedures.

Any hard water (well, from sources) becomes soft if it is boiled for a long time. Hard water can be made soft by adding baking soda to it at the rate of 1-2 teaspoons per basin of water or 1-2 tablespoons of borax.

And although personal hygiene includes rules that are very important for maintaining and strengthening human health, the short duration of the first space flights made it possible, and the complexity of implementing hygiene procedures, forced the crews of the first spacecraft to deprive the crews of the first spacecraft of personal hygiene standards familiar to earthly conditions.

The basic requirements of personal hygiene to keep the skin and hair clean, the oral cavity and teeth, clothes and shoes, bedding and other household items could only be partially fulfilled due to the short duration of flights. However, even in such conditions, these limitations do not go unnoticed. One of the strongest desires of astronauts when returning to earth is to take a hot shower.

With the increase in the duration of flights, the creation of long-existing orbital and planetary stations, the importance of personal hygiene in the overall complex of biomedical support for space flights increases immeasurably. Moreover, due to the specifics of the conditions on board space objects, hygiene procedures acquire a breadth and scale that far exceeds the level characteristic of human existence on the ground.

Features of the external environment in the cabins of spacecraft and flight factors unusual for humans can lead to changes in the physiological indicators of the vital activity of the human body, which will manifest themselves in metabolic disorders, in a decrease in the level of the body's defenses, etc. If we assume that all these phenomena will occur against the background of changes in the quantitative and species composition of the microbial flora surrounding a person, then personal hygiene measures acquire a multipurpose purpose.

At the same time, one cannot ignore the fact that personal hygiene procedures that are usually easily performed on the ground in space flight conditions will be associated with the solution of a number of very complex technical problems. Significant difficulties in equipping spacecraft compartments with sanitary and household appliances, in providing crew members with a sufficient amount of water, detergents (detergents) and other personal hygiene products, as well as the need to collect, store or regenerate flushing and household water under weightless conditions, have a significant impact on technical solutions to personal hygiene issues.

At the same time, the ideas about the necessary volume and frequency of personal hygiene procedures, familiar to earthly conditions, will require amendments that take into account the specifics of sanitary and hygienic conditions in the enclosed spaces of spacecraft.

It is quite obvious that in quantitative and qualitative terms, the nature of pollution here has some features due to the peculiar conditions for the physiology of the skin: limited human mobility, an unusual state of the autonomic nervous system and endocrine apparatus, high neuropsychic stress, a special water and food ration, etc. .

Features of physiological and hygienic conditions in spacecraft cabins, aggravated by the technical difficulties of creating sanitary facilities, lead to the need to develop some new, perhaps somewhat different from earthly, recommendations on the rational regime of hygienic measures and the definition of a set of tools designed to comply with the rules personal hygiene.

Naturally, the task set can be fully and successfully solved only if all aspects of the influence of unusual space flight factors on the human body as a whole and on its skin integument in particular are studied.

Of particular interest for personal hygiene is the study of sanitary and hygienic conditions in the cabins of spacecraft, clinical, physiological and biochemical indicators of the state of the skin and oral cavity of a person, determining the nature and degree of contamination of his skin and clothes with waste products and microbial flora.

Personal hygiene of astronauts

Modest at first glance, the issues of personal hygiene of a person on board a spacecraft for a long time remained in the background in the huge program of biomedical research that was carried out in the first decade of space exploration.

This situation was explained primarily by the fact that the researchers faced more

The most important problems associated with the elucidation of the fundamental possibility of human survival under the influence of extreme space flight factors.

Sanitary and hygienic conditions in the cabins of spacecraft.

Characteristics of pollution and their sources

The main influence on the formation of sanitary and hygienic conditions in the cabins of spacecraft is the fact that these rooms are completely protected from any pollution from the outside.

In the conditions of small, isolated, previously thoroughly cleaned and disinfected rooms with air conditioning, external contamination of the skin and clothes of astronauts will be determined by dust generated from clothes, shoes, bedding and equipment coating materials, food residues, particles of feces or urine that accidentally got into cabin when using sewage

devices. However, the main ones under these conditions will be endogenous pollution, the source of which is the human body - its skin. Secretions of sweat and sebaceous glands, torn off particles of the epithelium, particles of hair will make up a significant part of the pollution of the environment, the skin and clothes of astronauts.

In table. 2 shows data from a study to determine the magnitude of endogenous pollution in the cabin of a spacecraft.

Table 2. Mass and volume of waste in the closed space of the cabin of a highly maneuverable manned spacecraft (per 1 person/day)

Among the gaseous products emitted by humans, substances such as ammonia, carbon monoxide and dioxide, saturated, unsaturated and aromatic hydrocarbons, various aldehydes, ketones, lower fatty acids, alcohols and esters were found - up to 21 compounds in total. Many of these substances can be toxic, as they enter the atmosphere in large enough quantities. At the same time, some authors emphasize that a significant part of the harmful impurities appear as a result of the destruction of the excretory products of human sweat and sebaceous glands, and draw attention to the great importance of hygiene procedures in this aspect.

Studies to determine the microbial contamination of the environment in the cabins of spacecraft and their simulators have shown that man is the main supplier of microbial aerosols. The increase in the number of microorganisms in the air occurs mainly due to coccal microflora (Staphylococcus aureus and skin, b-hemolytic streptococcus, etc.).

During the flights on the Apollo 7 and Apollo 8 spacecraft, it was found that changes were taking place in the bacterial and fungal flora, which primarily included the exchange of microorganisms between crew members and increased growth of gram-positive microorganisms, such as Staphylococcus aureus and b-streptococcus, with some inhibition of the growth of anaerobic microflora. These data indicate that the conditions of space flight can lead to the dominance of those microbes, the growth of which is inhibited under normal conditions.

In the cabin atmosphere of the Gemini 10 spacecraft before launch, common airborne bacteria found in dust, skin and waste products were found. After the flight, only microorganisms were found, usually found only in dust.

One of the effective methods for disinfecting the spacecraft cabin air environment is air filtration through bacterial filters installed in the gas environment regeneration system. However, a decrease in the level of microbial contamination of the air can be achieved, apparently, by a rational regime of hygienic procedures, that is, by the timely removal of microorganisms from the surface of the skin.

The condition of the skin and its pollution

The studies carried out in various scientific centers made it possible to substantiate the need for certain hygiene procedures and evaluate their significance in the overall chain of medical and biological support for space flights. These studies made it possible to study the state of the skin and oral cavity of a person in conditions of prolonged deprivation of his usual volume of hygiene procedures.

Already the first experiments confirmed the obvious proposition that depriving a civilized person of the opportunity to observe the elementary rules of personal hygiene, even for a short period, leads to undesirable neuropsychic stress, although there are no noticeable deviations in the objective indicators of the state of the skin. cover. Almost all the subjects, after 10-12 days of the experiment, noted a great desire to take a bath and change underwear, to "really" wash. This desire usually haunts the subjects during the entire experiment, the duration of which is more than two weeks. It appears on the 7-10th day, when the subjects most often begin to notice itching of the scalp and an unpleasant odor from linen and body. Subjects complain that they feel “mangy”, “polluted”.

When assessing the living conditions in the experimental chamber, the “lack of water for washing” indicator is rated by the testers as one of the four most annoying factors of life in a limited space of small volume. In contrast, when subjects are allowed to use detergents and change clothing, soiling and odors rank 15th and 16th respectively among the 19 assessed irritants.

Clinical observations of the condition of the skin and oral cavity show that only in some cases there are minor skin reactions in the subjects. A sedentary lifestyle of the subjects leads to a sharp decrease in the process of exfoliation of keratinized epidermal scales in the area of the plantar surface of the feet, as a result of which a pronounced layering of horny masses is observed on these surfaces. In some subjects, vulgar skin diseases are observed, among which the main place belongs to ostiofolliculitis. Ostiofolliculitis are localized mainly in the buttocks and thighs, i.e., in places of greatest pressure, friction and moisturizing of the skin. Ostiofolliculitis is noted on the skin of the face and neck in subjects who wear helmets for several days. Dermatitis is found only in places where biotelemetric sensors are applied. Isolated cases of the appearance of boils are the result of complications of acne and ostiofolliculitis. At the same time, it is indicated that the occurrence of skin diseases cannot be attributed only to restrictions in the implementation of hygiene measures.

Thus, numerous studies indicate that depriving a person of the possibility of carrying out full-fledged hygiene procedures for a long time does not lead to any serious complications in the clinical condition of the skin. Only some subjects have dry skin, especially the scalp, as well as irritation of skin areas in places where electrodes are constantly worn. Increased itching of the whole body is observed only at high ambient temperatures.

During the flights of the Apollo 7 and Apollo 8 spacecraft, as well as during the flights of the Gemini spacecraft, only minor disturbances in the condition of the astronauts' skin were noted, expressed in seborrheic changes on the scalp and face.

Some anxiety is caused only by the condition of the oral cavity and teeth. The lack of habitual hygienic oral care usually leads to a sharp deterioration in the condition of the teeth and mucous membranes. There is an unpleasant smell from the mouth, plaque on the teeth increases, they stain, various degrees of gingivitis develop.

Studies of the physiological and biochemical parameters of the skin of the subjects do not reveal any significant changes in the functional state of the skin. The sebaceous function of the skin is not disturbed. The level of the lipid saturation layer of the skin surface and the rate of its recovery in the course of the experiments change little.

The shift in the pH of the skin surface to the acid side, found in separate experiments, does not indicate biochemical changes in the skin, but is a consequence of the appearance of low molecular weight free fatty acids in the composition of skin contaminants.

formed as a result of the destruction of the secretion of the sebaceous glands.

The study of skin bactericidal activity in the course of long-term experiments indicates its gradual decrease. The bactericidal index of the skin of the forearm, which was 90-95 units in the initial state on the iron, after 30 days of the experiment decreases to 60-70 units. According to other researchers, the bactericidal activity of the skin during the experiment remains at the initial level, and only in the aftereffect period is there a tendency to some decrease. Despite the fact that the studies conducted have not obtained sufficiently convincing data on a decrease in the bactericidal function of the skin, there is every reason to expect that in real long-duration flights we may encounter this negative phenomenon.

The impact of such extreme space flight factors as dietary habits, traumatic shock, extensive body irradiation, hypersecretion and hyposecretion of hormones leads to a decrease in the body's resistance to infection, to a decrease in its immune resistance, including, possibly, to a decrease in the bactericidal function of the skin.

A study of the nature and degree of contamination of the surface of the skin and linen showed that these contaminations mainly consist of the waste products of the human body - the secret of the sebaceous and sweat glands, particles of the epidermis, fallen hair, as well as dust from clothing and microbial cells.

The average daily total contamination of the skin and clothes with chlorides under the conditions of a separate experiment ranged from 117 to 403 mg/day, and with organic substances - from 335 to 886 mg O 2 /day. The amount of lipids on the skin surface (saturation layer) in certain areas of the back and chest only slightly exceeded the level characteristic of these areas of the skin under normal conditions.

This circumstance testifies, on the one hand, to the sufficient sorption properties of underwear and its good cleansing effect, and on the other hand, to the normal state of the sebaceous function of the skin.

The fabrics of linen and clothing absorb about 90% of chlorides and up to 80% of organic substances. The ability of clothes to cleanse the skin of the products of its vital activity depends both on the type of fabrics used and on the design features of underwear.

Of great importance for substantiating personal hygiene measures are data obtained from studying the nature of changes in the chemical composition of contaminants that have been on the surface of the skin for a long time.

Under the influence of air oxygen, moisture and enzymes secreted by the skin and microorganisms, the main part of the pollution - skin surface lipids (sebum secretion) undergo significant changes. At the same time, the acid number of lipids increases and the saponification number and iodine number decrease.

Esters of higher fatty acids and saturated compounds that are part of the pollution are destroyed with the formation of free lower and higher fatty acids, which in turn leads to a shift in the pH of the contaminated skin surface to the acid side, especially in areas with increased sebum secretion. The latter circumstance can be regarded from a hygienic point of view as positive, since with an increase in the acidity of the skin surface, an environment unfavorable for the development of microbial flora is created.

The study of the dynamics of microbial contamination of the skin surface under the conditions of spacecraft cabin simulators shows that the level of contamination of the skin usually increases only in the first 2-3 weeks of the experiment. In the subsequent period, the growth of the number of microorganisms in most areas of the skin stops. In areas of the skin in the chest, back, and head, stabilization of the microflora occurs when the number of microorganisms exceeds the initial one by 2.0/3.5 times. On the skin of the plantar surface of the feet, in the inguinal region and on the buttocks, there is a tendency to increase the level of contamination even when the initial level is already exceeded by 7-12 times. In the area of the forearm, no pronounced increase in the level of microbial contamination was observed during the experiments. In studies involving eight subjects on a simulator with a 28-day exposure to flight-simulating factors, no changes in the species composition of microorganisms were noted. All subjects remained healthy, there was no decrease in resistance to infection throughout the entire observation period.

During the 14-day space flight under the Gemini program, no noticeable changes were found in the microbial composition of the skin. Crew members of the Gemini 7 spacecraft showered daily with soap containing hexachlorophene and sulsen shampoo during the two-week pre-flight period. In bacterial cultures taken from some areas of the skin and from the pharynx before and after the flight, an increase in the number of microbes of the fecal flora in the perineum and a decrease in the number of microbes in the mucous membrane of the pharynx was found. The test results for the presence of fungi were negative. Significant differences in the composition of microorganisms and the exchange of microflora between crew members were not observed.

A significant increase in microbial populations on the skin under the conditions of a long experiment was noted only in some cases, which, apparently, is a consequence of the influence of some random circumstances and features of the research methodology.

The species composition of the microbial flora on the surface of the skin and in linen was characterized mainly by saprophytic species: cutaneous and Staphylococcus aureus, diphtheroid bacilli and sarcins. In some cases, hemolytic forms of staphylococci were noted.

In the oral cavity, an increase in the number of yeast-like fungi of the genus Candida was found, with some signs of pathogenicity. In some cases, streptococci (S. faecalis, S. salivarius, S. mitis) were isolated from the oral cavity and throat, and various anaerobes were isolated from the throat and anus.

It should be noted that the level of microbial contamination should be considered not only as a function of the body's resistance, but also as a function of the environment that is created on the skin and in underwear as a result of changes in the chemical composition of skin surface lipids. In this regard, the most unfavorable conditions are areas of the body with increased sweat, but low production of sebum - armpits, inguinal region, feet. In these areas, the highest level of microbial flora is recorded.

The amount of microflora and its species composition on the shaved part of the head, in the ears, nose, forearm, chest, back, in the umbilical fossa indicate that the listed areas of the body are not critical in terms of hygiene requirements. For the population of microbes on the skin in the underwear space, favorable conditions are created only when sweating, after washing and changing clothes.

The appearance of an environment with bactericidal properties on the lipid-contaminated skin surface (pH shift to the acidic side) gives grounds for a seemingly paradoxical assumption that unlimited washing of the skin, which removes all the products of the sebaceous glands, is not a rational measure and is not indifferent to the protective function of the skin. With regard to the conditions of a person's stay in the cabins of spacecraft, there is every reason to abandon the basic hygienic rule - the more often you wash, the better. Moreover, given the positive role of symbiotic microflora in the formation of the protective mechanisms of the human body, it can be considered doubtful the need for active influence on the saprophytic microbial flora through hygiene procedures. Imbalance of this microflora can cause dysbacteriosis and lead to a decrease in the body's resistance.

In this regard, when developing a set of hygienic measures for spacecraft crew members, one should take a differentiated approach to the procedure so familiar to terrestrial conditions.

The need to provide crew members with the opportunity to carry out full-fledged hygiene procedures is beyond doubt, despite the relatively safe clinical and functional state of the skin and its slight contamination under a limited hygiene regime under the conditions of experiments in simulators of spacecraft cabins. The versatility of aspects of personal hygiene in the specific conditions of space flight somewhat shifts the main focus of these activities and expands their motivation. The need for hygiene procedures is dictated not only and not so much by hygienic and physiological, but mainly by psycho-aesthetic, epidemiological and, possibly, toxicological aspects.

The peculiar way of life of cosmonauts should not be deprived of an important link in the habits and attitudes of earthly life, which, of course, is the observance of the rules and procedures of personal hygiene.

Without fulfilling this provision, it is impossible to talk about creating acceptable living conditions and the necessary comfort in the cabin of a spacecraft.

Formulating in general terms the requirements for hygienic procedures and personal hygiene products in space flight conditions, the following main provisions should be taken into account:

1) hygiene procedures and personal hygiene products aimed at maintaining cleanliness of the body and oral cavity should contribute to the normal functioning of the skin, oral mucosa and teeth. Refreshing and cleansing the skin from endogenous and exogenous pollution, personal hygiene products should maintain the biochemical and physiological constants of the skin and its appendages at an optimal level, and also have a bacteriostatic effect in relation to automicroflora;

2) the systematic long-term use of personal hygiene products should not cause painful conditions in the human body, unpleasant subjective sensations, changes in skin color, the appearance of age spots and hyperkeratosis on it. Means should not sensitize the skin to ultraviolet and ionizing radiation;

3) personal hygiene products should not contain toxic, potent substances and allergens. They must be odorless and not produce gaseous products that could create explosive or flammable concentrations in the ship's cabin;

4) the use of personal hygiene products should be possible in zero gravity and when life support systems are operating on board the ship.

Obviously, these requirements can only be finally formulated in relation to the means for a specific case, based on the duration of the flight, the conditions in the cockpit and its technical equipment.

The volume of hygiene procedures,

their classification and types of personal hygiene products

When choosing one or another mode of hygienic measures, the main criteria are the duration of the flight of a spacecraft or station and their technical equipment. Naturally, depending on the duration of the flight, the volume of hygiene procedures and the completeness of their solution on board the ship will vary significantly. One thing is certain - for any duration of a space flight, procedures for hygienic care of the skin and oral cavity should be provided first of all.

For short-term flights (up to 10 days), these procedures may be limited to cleaning exposed skin and deodorizing the mouth.

For flights with a duration of two to four weeks, full sanitary and hygienic treatment of the body with a change of underwear, shaving of the beard and mustache and more thorough care of the oral cavity should be provided.

On flights lasting more than 4-5 weeks, it becomes necessary to trim the nails on the hands and feet and care for the hair of the scalp.

By analogy with personal hygiene in everyday life, these procedures can be conditionally divided into daily and periodic.

The first type should include procedures designed to replace our daily toilet, morning and evening washing, washing hands before eating and after using a sewage device, i.e. hygienic cleaning of exposed areas of the skin, shaving the beard, cleaning and deodorizing the oral cavity.

Procedures of the second type are designed to replace the usual shower, bath and visit to the hairdresser. These include a complete body wash and a haircut.

Naturally, each of these procedures, which is simple to perform on the ground, in space flight conditions requires the solution of complex technical problems or its replacement by some other procedure.

Classifying these hygienic measures according to their purpose, we can divide them into four main procedures: complete sanitary and hygienic treatment of the body; hygienic treatment of individual areas of the skin; oral hygiene; hair cutting, shaving and nail care.

For the purpose of a clearer and more detailed description of these procedures, we will consider each of them separately.

Full body sanitization

The main requirement for sanitary and hygienic treatment of the body is the removal of natural metabolic products from the surface of the skin, as well as particles of dirt, food debris and microbial cells. After treatment, the skin should be dry and clean, its biochemical and physiological constants should remain at the normal level.

Taking into account the peculiarities of sanitary and hygienic conditions in the cabins of a spacecraft, the main attention in choosing a method should be paid to the psychological factor. Ideally, the chosen method and the personal hygiene products used should leave after the hygiene procedure not only a feeling of cleanliness of the body, but also a feeling of “refreshment”, psychological comfort and relaxation.

The methods that are currently being considered involve the use for these purposes of various napkins, towels and sponges moistened with special washing or cleaning solutions.

In flights lasting up to 3-5 weeks, periodic (at least once every 5-6 days) use of these products (combined in time with a change of linen) gives a sufficient hygienic effect, theoretically equivalent to washing in the shower. However, in the psychological aspect, the use of such means leaves much to be desired. Body treatment instead of a pleasant and refreshing shower procedure turns into a tedious prosaic task of “wiping” the body.

More promising for creating psychological comfort and habitual earthly conditions on board a spacecraft are the methods of sanitary and hygienic treatment of the body using automatic sponges and special shower installations. The most convenient, effective and acceptable is the shower method of complete body treatment. Regular use of the shower during a long space flight will help maintain a sense of psychological comfort and relieve a significant part of the astronauts' emotional stress. But significant technical difficulties and the need for large weight and energy resources make it possible to create such installations only on ships and stations with a long flight time.

One of the options for complete sanitization using an automatic sponge is shown in fig. 1.

The sponge device consists of an applicator held by a handle that delivers a metered dose of water and detergent to the skin surface through the pores of the sponge. The sponge on the applicator is placed in a ring surrounding it, designed to suck the solution from the skin surface. Complete sanitary and hygienic treatment with a minimum washing efficiency was carried out within 22 minutes. However, despite the fact that this device was almost 2.8 times lighter than a shower installation, it, like other methods, lost in the psychological aspect.

On fig. 2 shows one of the options for a promising way of complete treatment using a shower installation. The shower unit is approximately 76 cm in diameter (30 inches) and 204 cm long (80 inches). A naked person enters the installation and fixes himself with straps to maintain a certain position when bathing. Warm water enters through the shower screen of the device, which the astronaut holds in his hands. Water is removed from the cabin's artificial atmosphere by means of a separator. The shower device ensures the dissolution of the detergent and the supply of the solution through the shower screen. The surface of the body can be dried with a blowing fan, followed by wiping with a dry towel. Drying of the body can also be done by sucking water droplets through a sponge. Using a stream of warm air after the removal of residual water speeds up the drying process. It is expected that a weightless shower set will require about 1.89 liters of water per minute during the entire wash period (4 minutes).

The shower installation designed for the American Skylab orbital station consists of two cylindrical flanges and a transparent shirt made of Beta fabric with stiffening rings.

One of the flanges (rings) is permanently attached to the floor in the utility compartment, and the second one, during operation, to the ceiling with quick-release clamps. A spray horn and a suction head are attached to the ceiling flange, and elastic hoses with quick couplings are attached.

Rice. 1. Diagram of an automatic sponge

1 - fan,

2 - water separator,

3 - pump,

4 - filter,

5 - flexible hose,

6 - detergent supply,

7 - cabin air,

8 - sponge applicator

Rice. 2. Schematic of the shower installation

1 - common canister,

2 - shower installation,

3 - fixing stirrups,

4 - hot water,

5 - cold water,

6 - detergent,

7 - pump,

8 - water separator and filter,

9 - water to the water system,

10 - timer

The shower receives water from the onboard water supply. This water is stored and consumed from a special water module, which has a capacity of 2.72 kg. The water module functions normally at a pressure of 517-1292 mm Hg. Art. The module receives 1.81 kg of hot water (60°C) from the heater and additionally cold water. All this mouth

The dispenser delivers a water flow of 200-800 ml/min for 3 minutes.

The used water is collected and returned by means of a suction head to a collector with replaceable plastic bags. These bags can be removed through the sluice into a vacuum without fear of tearing them.

The Skylab shower facility allows each cosmonaut to bathe at least once a week during the entire flight.

If, for one reason or another, the shower method of complete sanitary and hygienic treatment of the body is not suitable, then moistened wipes and towels for multiple or disposable use will be its replacement. At the same time, devices must be provided for the safe storage of used wipes in the cabin or their removal from the spacecraft.

Hygienic treatment of individual areas of the skin

This type of hygienic procedures is designed to replace daily washing in earthly conditions. This includes cleaning the skin of the face and hands after and before going to bed, after using sewage devices and before eating, as well as periodically (once every 2-3 days) wiping hygienically critical parts of the body (armpits, groin, feet and etc.).

In ordinary life, there are many ways of sanitary and hygienic treatment of limited areas of human skin. This is wiping the skin with various colognes, lotions, creams and treatment with disinfectant solutions, and ultraviolet irradiation. However, the only practical solution to this problem in space flight conditions is to wipe the skin with special moistened wipes for multiple and disposable use.

Wipes of this type were quite successfully used in long-term experiments on the ground, as well as together with cloth towels for wiping dry during flights under the Gemini and Apollo programs. In space flights under these programs, small wipes measuring 8.9X10 cm (3.5X6 inches) were used, moistened with an antiseptic solution of hyamine 1620 (hyamine 1620) and packed with one-time rations of astronauts. A similar method of treating open areas of the skin was also used in flights under the Vostok and Soyuz programs.

The method of using napkins for hygiene procedures in these conditions turned out to be the most acceptable. It allows you to clean and refresh the skin well enough and keep the skin in a hygienically satisfactory condition.

In addition, after intended use, the wipes can be used to wipe various surfaces of cabin equipment.

Oral hygiene

Oral hygiene is one of the central places among hygiene procedures. And this is not accidental, since the main task of oral hygiene is to eliminate local factors that contribute to the development of caries, periodontal disease, diseases of the mucous membrane, and the appearance of bad breath. The state of the whole organism as a whole largely depends on the normal state of the oral cavity, because such important functions as receiving, grinding and partially chemical processing of food are carried out in the oral cavity.

The oral cavity is a reservoir of a huge number of microorganisms. The microflora of the oral cavity is divided into permanent and random. Facultative anaerobic α- and γ-streptococci, strictly anaerobic bacteria, actinomycetes and spirochetes predominate in the composition of the constant. The composition of the permanent microflora, specific for the oral cavity, is supported by evolutionarily developed relationships of symbiosis and antagonism between microbial species and the action of the body's defenses. Some pathological processes in the oral cavity are accompanied by pronounced shifts in the composition of the permanent microflora. So, with ulcerative-necrotic lesions of the oral mucosa, all strict anaerobes (fusobacteria, spirochetes, vibrios) multiply intensively, with dental caries - anaerobes and lactic acid bacteria.

Random microflora includes microorganisms of other mucous membranes and skin, saprophytes of the external environment and pathogenic microbes.

Group D streptococci (enterococci), b-hemolytic streptococci of group

A, C, F and G, pathogenic staphylococci, corinobacteria, Candida and Nocardia fungi, herpes viruses, epidemic paratitis and measles.

The permanent flora of the oral cavity serves as a biological barrier due to antagonism with many types of microbes penetrating from the outside. Destruction of this barrier by various influences (for example, the use of antibiotics, bactericides, etc.) leads to intensive reproduction of random forms of flora resistant to these influences. There are "drug" lesions of the mucous membrane, the culprits of which are most often fungi (Candida), enterococci and gram-negative intestinal bacteria.

With a decrease in the resistance of the tissues of the oral cavity and a change in the reactivity of the organism as a whole, the pathogenic properties of some representatives of the symbiotic microflora may appear.

Chronic inflammatory processes in the oral cavity can cause allergic reactions in the body and contribute to focal infection, which most often occurs as chronic intoxication.

All this is of particular importance in the development of hygienic measures for the oral cavity during flight aboard a spacecraft.

It is known that oral hygiene consists of regular brushing and rinsing the mouth. For this, various toothbrushes, toothpastes and powders, toothpicks, elixirs, rinses, etc. are usually used.

The results of long-term experiments in simulators of spacecraft cabins showed that the greatest clinical changes are observed in the condition of the teeth.

In table. 3 shows data on evaluating the effectiveness of various oral hygiene procedures in a series of long-term experiments.

As can be seen from the above data, the use of a toothbrush and toothpaste gives the greatest effect. Carrying out partial hygienic procedures usually led to the development of gingivitis of varying degrees in all subjects. Bleeding gums in some subjects developed three weeks after the start of the experiment and persisted throughout the experiment.

Table 3. Evaluation of the effectiveness of oral hygiene procedures in various experiments

In space flights under the Gemini program, the oral cavity was cleaned with a toothbrush and chewing gum. On flights on the Apollo spacecraft, crew members were provided with small tubes (about 56.5 g) of toothpaste and toothbrushes. According to the daily routine, the teeth were brushed after each meal in order to prevent the formation of plaque on the teeth and the development of gingivitis.

For long-duration space flights, only the most effective procedures, which involve the use of a toothbrush and toothpaste, can be recommended. At the same time, electric toothbrushes with a forced supply of liquid toothpaste can be offered, which will ensure the collection of the washing liquid through a special oral air suction system for removing used water.

Haircut, beard and mustache shaving, nail care

Hygienic hair care procedures include periodic cutting of hair on the head, shaving of the beard and mustache.

The life expectancy of hair ranges from several months (for vellus) to 2-6 years (for long) and is related to the time of year, sex and age of a person. From the scalp of an adult, 25-100 hairs in the telagen phase fall out daily.

The duration of the growth cycle of long human hair (anagen phase) is from 2 to 6 years. On average, the hair located on the top of the head grows daily by 0.35 mm, on the chin - 0.38 mm, under the armpits - 0.3 mm, in the eyebrow area - 0.16 mm. In women, hair grows faster on the top of the head, in men - under the armpits. Hair grows faster in summer than in winter.

It is noted that the amount of permissible beard and hair growth is determined by both cultural habits and professional considerations. There comes a moment when the grown hair causes discomfort and can lead to the development of direct irritation due to the difficulty of normal vision.

It has been established that after 5-6 weeks of staying in a closed space simulators of spacecraft cabins, the subjects have a desire to cut their hair and mustaches and trim their beards. Growing a beard did not cause any particular complications in the conditions of ground-based experiments.

Taking into account the difficulties in carrying out hygiene procedures and the specifics of sanitary and hygienic conditions in the cabins of spacecraft, during long flights, the recommendations of hygienists will oblige astronauts to have a short haircut and shave their beards and mustaches.

The main problem of hygienic hair care in space flight conditions is to prevent particles of cut or shaved hair from entering the cabin atmosphere.

Special electric razors with suction have been developed to catch cut hair particles. However, conventional safety razors and shaving cream were the most acceptable. In space flights under the Soyuz and Apollo programs, crew members used ordinary safety razors and shaving cream applied to the skin of the face with fingers without a brush. After shaving, the razors were wiped dry with napkins, and the hair particles remained fixed with cream and did not pollute the cabin atmosphere.

Hair cutting on the head on long flights can be done electrically.

electric or pneumatic clippers equipped with suction and a hose to remove the cut hair to the waste collection system.

Hygienic nail care consists in the timely cutting of the nail plates of the fingers and toes.

The nail plate consists of flat polygonal horny scales. The growth rate of nails is strictly individual and depends on the age of the person, the state of the body, profession, etc. Complete renewal of the nails of the fingers occurs within 95-115 days. Within one day, the nail grows by 0.1-0.2 mm.

Studies have shown that in half of the subjects, the fingernails grow so long after four weeks of the experiment that they begin to interfere with the performance of work operations and disrupt the writing process.

The need for clipping of toenails usually occurs 6-7 weeks after the start of the experiment.

In spacecraft and manned stations with a flight duration of more than 4-5 weeks, it is necessary to provide for the possibility of cutting the nails of the fingers and collecting the sheared scales (particles). For these purposes, special sealed boxes equipped with a suction air system and connected to a solid waste collector can be used. Boxes must be equipped with openings with cuffs that tighten the arm or leg and allow cutting nails inside the box. In order to save space in the ship's cabin, the box can be made in the form of a folding system.

As one of the possible methods of nail care, the usual filing of nails with manicure files can also be suggested. However, in this case, the procedure will need to be carried out much more often (after 2-3 days) and carried out near the air inlet of the air conditioning system, equipped with a filter to collect nail scales.

Concluding the discussion of the issues of providing astronauts with flight clothing and personal hygiene products, it should be emphasized that they were discussed on the basis of data obtained in ground-based experiments lasting no more than 90 days and in short-term space flights. However, it can already be said with sufficient certainty that for flights of much longer duration (from 100 to 500 days and more), the fundamental solution of these problems is unlikely to undergo radical changes. It can be said with absolute certainty that successful long-term flights are possible only if conditions are provided in the living and working compartments of spacecraft that would create the necessary comfort and convenience. In this regard, the issue of providing astronauts with flight clothing and personal hygiene products plays an important role.

The technical designs of ships for long-term flights should provide for the possibility of carrying out personal hygiene procedures in full on board, washing clothes and washing the body, repairing clothes and storing supplies of personal hygiene products and sets of flight clothes, since optimal habitability conditions will have a positive effect on the overall performance of astronauts. -operators and will allow them to successfully complete the flight mission.

The hygiene of any person begins with daily procedures, and the baby must be taught to do this from birth. Wash your eyes every morning with a cotton pad dipped in warm boiled water. You can also wipe the whole face, especially if the room is hot, this will make the girl feel better.

Also wipe the baby's hands - after all, she grabs various objects, and do not forget about the heels - this is an excellent tempering procedure.
Pay special attention to the armpits and neck of the baby, because a lot of dirt and sweat accumulate there. If these areas are not cleaned in a timely manner, irritations, diaper rash appear, bringing discomfort to the child. Wipe with a cotton pad, trying to remove all contamination, especially if the doctor forbade taking baths for some time (after vaccination or during illness). Do not wrap the girl in clothes immediately after wiping - let the skin dry.

As for the baby's ears, you do not need to constantly clean them with cotton swabs - you can damage the delicate skin. Remove only visible dirt as it accumulates. The same is with the girl's nose. If you have a runny nose, use baby drops to soften nasal mucus and gently remove it with twisted cotton swabs.

And, of course, bathe a little girl every day, it is pleasant and good for the whole body. You can add three to four crystals of potassium permanganate, a decoction of chamomile, a little sea salt and coniferous extract to the water. All this will strengthen your daughter's immunity, help her grow strong and healthy.
Do not forget to talk with the baby during the procedures, say that she is the best and most beautiful, and then manipulations that are unpleasant at first glance will not cause discomfort to the baby.
Genital Care

The hygiene of the genital organs of a newborn girl is one of the most significant moments, and the mother needs to carefully monitor the cleanliness of the baby, observing important rules. Every morning and evening, you need to wash the genitals with warm water, and after defecation, be sure to wash with soap and water. Hold the girl face up (rather than lay face down on one arm, as boys are groomed) and wash from the pubis to the anus. This is necessary so as not to contaminate the delicate organs of the baby with intestinal secretions and not cause various diseases.
Do not forget about the cleanliness of the inguinal folds - they also need to be thoroughly cleaned to avoid the appearance of diaper rash or cracks in the skin.
For intimate health care of a newborn girl, use a mild cream soap, but choose one that does not contain perfumed fragrances. You should not wash the baby with laundry soap or water with potassium permanganate - they dry the skin very much, breaking the alkaline balance.

Do not wipe the girl with sharp or pressing movements, it is better to slightly blot the body with a towel and let it dry naturally. And then lubricate the skin with baby cream.

Many young mothers are worried about a white coating on the genitals of a newborn, and they begin to remove it with cotton pads or sticks, injuring delicate skin. This should not be done, because white plaque is nothing more than a secret that protects female organs from pollution. With proper care, it disappears on its own.
If the irritation nevertheless began, wash the baby with a decoction of chamomile or calendula and be sure to show the child to a doctor who will prescribe a gentle, effective and soothing treatment.
Baby clothes care

Of no small importance for the hygiene of the newborn is the care of the girl's underwear. Use panties, pants and diapers made from natural fabrics that allow air to pass through and allow the skin to breathe. Do not get carried away using diapers, this is fraught with irritation and diaper rash on the baby's pope, use them only while walking, traveling to the hospital or visiting. At home, the baby can be in clean diapers or sliders.

Wash clothes either by hand using laundry or antibacterial soap or in a machine, but always with baby powder. Clothing for newborns should be thoroughly rinsed to remove any detergent residue. For at least the first few months, iron the baby's underwear on both sides with a hot iron.