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PubMed2005

A comparison of post-operative complications following wisdom tooth surgery performed with sterile or clean gloves.

This randomised prospective study aimed at evaluating possible differences in the post-operative complication rate following lower wisdom tooth surgery performed with either sterile or clean surgical gloves. The microbiological profiles of the tooth sockets and glove surfaces were also evaluated and compared. A total of 275 ASA I, non-smoking and non-drinking patients consented to be randomly assigned into two groups for lower wisdom tooth surgery, performed by operators wearing either sterile or clean gloves. All the patients returned for a post-operative assessment visit one week later. An additional 40 patients were recruited and randomised into the sterile glove group (n = 20) or the clean glove group (n = 20) for the microbiology study. Specimens were taken from the glove surfaces and the post-operative socket wounds during wisdom tooth surgery. This clinical trial showed no significant difference between the sterile and clean glove groups in the incidence of acute inflammation, acute infection and dry sockets in the wounds. No single peri-operative factor had a statistically significant effect on post-operative pain intensity. Most of the bacterial isolates from the clean gloves were Gram-positive cocci or spore-forming bacilli. The total number of colony forming units and the variety of bacterial isolates from the socket wounds in the sterile and clean glove groups were similar. The study concluded that there was no advantage in using sterile surgical gloves rather than clean gloves to minimize post-operative complications in wisdom tooth surgery. There was also no apparent relationship between the bacteria contaminating the clean glove surfaces and those isolated from the socket wounds.

Adolescent↗

PubMed1996

A prospective, controlled study showing that rubber gloves are the major contributor to latex aeroallergen levels in the operating room.

BACKGROUND: Although protocols have been published for reducing natural rubber latex exposure in medical environments, there are no objective data documenting their effectiveness. OBJECTIVE: We prospectively studied the impact of a single intervention, substitution of low-allergen-containing latex gloves for high-allergen-containing latex gloves, on latex aeroallergen levels in a single operating room (OR). METHODS: We sampled OR air on 52 consecutive days, including 33 surgery days and 19 nonsurgery days. On each surgery day all personnel wore either high-allergen gloves (n = 18 days) or low-allergen gloves (n = 15 days). Latex aeroallergen levels (in nanograms per cubic meter) and extractable latex glove allergen contents (in allergen units per milliliter) were measured by inhibition immunoassays. An on-site study monitor recorded the number of gloves used, the total time spent by all patients in the OR each day (OR time), and the total time of all procedures for each day (operating procedure time). RESULTS: Latex aeroallergen levels during low-allergen glove use days (mean, 1.1 ng/m3; median, 0.9 ng/m3; range, 0.1 to 3.5 ng/m3) were significantly lower than on high-allergen glove use days (mean, 13.7 ng/m3; median, 7.7 ng/m3; range, 2.2 to 56.4 ng/m3) (p < 0.001) but not significantly different from that on nonsurgery days (mean, 0.6 ng/m3; median, 0.3 ng/m3; range, 0.1 to 3.6 ng/m3). Latex aeroallergen levels were strongly correlated with the total number of gloves used on designated high-allergen glove days (r = 0.66, p = 0.003). There was no appreciable day-to-day carryover of latex aeroallergen. CONCLUSIONS: The substitution of low-allergen-containing latex gloves for high-allergen-containing latex gloves can reduce levels of latex aeroallergen by more than 10-fold in an OR environment.

Air Pollutants, Occupational↗

PubMed1998

Incidence of latex sensitization among latex glove users.

BACKGROUND: Although there are several reports of the prevalence of latex sensitization among health care workers, the incidence of sensitization is unknown. OBJECTIVE: The objective of this study was to estimate the incidence of sensitization among latex glove users at a hospital in Hamilton, Ontario, Canada. METHODS: Workers with negative results to the skin test at baseline were followed prospectively over 1 year, some wearing powdered gloves and others using powder-free gloves. They were reevaluated in 1995 with a questionnaire and skin prick test (SPT) sensitivity to latex reagents, three common inhalants, and six foods. A conversion was defined as a (new) latex SPT with wheal diameter at least 4 mm greater than saline control. Glove extracts were assayed for antigenic protein, and air samples were obtained to estimate exposure to airborne latex protein. RESULTS: During powdered glove use, personal exposures ranged from 5 to 616 ng/m3, whereas during powder-free glove use, all but two results for air samples were below the limit of detection (about 0.1 ng/m3). During the study period, the protein concentration in the powdered gloves, initially mean 557 microg/gm of sample, declined at a rate of 295 microg/gm per year (p < 0.0001). Of the 1075 SPT-negative participants at baseline, 479 were working in eligible wards, and of these, 435 (91%) participated in follow-up, 227 using powder-free gloves and 208 using powdered gloves. We identified four conversions, two (1.0%) in the powdered glove group and two (0.9%) in the powder-free group. The two participants using powdered gloves were the only converters who were symptomatic. The significance of skin test conversions identified in the powder-free group, both asymptomatic patients, is unclear. The limitations of the study are discussed, including the limited power, the declines in latex protein concentrations, and the possibility of information (observer) bias. CONCLUSION: To our knowledge, this represents the first reported estimate (about 1%) of incidence of sensitization in hospital personnel using latex gloves.

Cross-Sectional Studies↗

PubMed1991

Glove use in clinical practice: a survey of 2000 dentists in England and Wales.

Attitudes to glove wearing by dentists practising within the NHS Regulations were tested by means of a questionnaire distributed to 2000 dentists in England and Wales. The response was 76.5%. The results indicate that 68% of the respondents wore gloves routinely for all patients and procedures, 3% never wore gloves, while the remainder (29%) wore gloves for only selected patients or selected procedures. Reasons given for not wearing gloves routinely included problems of comfort, loss of tactile sensation and the risk of cross-infection, which was perceived to be small. Of the routine glove wearers, only 12% changed gloves between patients, cost being considered to be a factor by 57% of respondents who used gloves for more than one patient. The results indicate that the respondents practising and personal details had an influence on the pattern of glove wearing, with single-handed practitioners and those who graduated before 1979 being less likely to wear gloves routinely. Comparison with the findings of earlier studies of similar type suggest that there is increased awareness in the dental profession of the necessity for glove wearing, but that there is still a need to encourage routine glove use, especially amongst certain groups of GDPs.

Age Factors↗

PubMedDate not supplied

A comparative analysis of glove permeation resistance to paint stripping formulations.

Although there is a wide variety of work gloves available to users of commercial paint stripping products, there are no published studies examining which type of gloves provide the best protection. To address this need, a multiphase study was undertaken to evaluate how several types of gloves resist multichemical-based paint stripping formulations. Due to the wide range of commercial paint stripping formulations available, seven categories of surrogate paint stripper formulations were created to evaluate glove performance initially. Twenty different glove types were identified for initial evaluation. Degradation resistance screening was carried out for each glove style and paint stripping formulation. Screening results were used to identify those glove styles least affected by the surrogate paint strippers. Those gloves were then evaluated for their resistance to permeation using continuous contact testing based on ASTM Test Method F 739. Glove styles showing extensive permeation with early breakthrough were then evaluated to see how they performed with only intermittent contact with the surrogate paint strippers using a modified form of ASTM Test Method F 1383. These results were used to select glove styles to be tested using commercially available paint stripping products. Gloves made of plastic laminate and butyl rubber were the most effective against the majority of paint strippers. More glove styles resisted permeation by N-methylpyrrolidone and dibasic ester-based paint strippers than conventional solvent products such as methylene chloride, methanol, isopropanol, acetone, and toluene. The study also found that decreased contact time caused relatively little change in permeation resistance and that the surrogate paint stripper data did not always accurately predict resistance to the commercial paint stripper formulations.

Acetone↗

PubMed1989

What is leaky can be risky: a study of the integrity of hospital gloves.

One thousand six-hundred and eighteen medical gloves were tested to determine whether, with current increased demands, these gloves are of high quality, i.e., free of leaks. The risk of exposure to potentially infected fluids when using leaky gloves was also estimated. Using a four-stage leak test, no significant difference was found between 64 of 790 (8.1%, range 0% to 44.4%) unsterile latex gloves and 11 of 210 (5.2%, range 1.7% to 21.7%) unsterile vinyl gloves (p = .21). Sterile surgical gloves (7 of 618, 1.13% [range 0% to 3%]) had fewer leaks compared to unsterile latex and vinyl gloves combined (p less than .0001). The safranin test was positive in 27 of 28 (96.4%) leaky gloves tested, indicating a high risk of exposure to potentially infected fluids when leaky gloves are used. Because of these findings, elements of "universal precautions" such as changing gloves after each patient contact and good handwashing after using gloves should be carefully observed. There is a need for the Food and Drug Administration to establish more stringent guidelines for manufacturing gloves and to verify compliance with these guidelines.

Acquired Immunodeficiency Syndrome↗

PubMed2005

Efficacy of double gloving with an intrinsic indicator system.

BACKGROUND: Blood-borne infection is an ever-present fear for medical professionals, especially surgeons and operating room personnel. Safety is paramount, and the reliability and efficacy of surgical gloves are crucial, as gloves are the most important barriers protecting hospital personnel and patients. Unfortunately, glove perforation rates are as high as 78% in high-risk procedures. As well as being efficacious, surgical gloves must be comfortable and easy to don, and when holes are present, it is imperative they be detected expeditiously. The purpose of this double-blind randomized study was to evaluate the ability of participants to locate 30-micron laser holes in surgical gloves while performing simulated surgery and to evaluate the Biogel Indicator Glove System, which reveals punctures. METHODS: Twenty glove configurations (eight single, twelve double) were tested, half of which had laser-created holes. Each of the 25 participants tested and evaluated 20 configurations randomly. Simulated surgery terminated when a hole was identified by the participant or at the end of two minutes, whichever occurred first. Participants also rated their perceptions of each glove's features on questionnaires, all of which were returned, with 95.8% being complete. RESULTS: Participants found 84% and 56% of the holes in the two indicator systems, latex and synthetic, in an average of 22 seconds and 42 seconds, respectively. In the worst-performing latex and synthetic glove configurations, participants found only 8% and 12% of the holes at an average of 47 seconds and 67 seconds, respectively. Indicator gloves were highly rated for comfort and ease of use. CONCLUSIONS: Double gloving with an indicator system provides the best protection and allows the timeliest identification of perforations. Participants failed to identify most of the holes in the non-indicator gloves.

Double-Blind Method↗

PubMed1993

Release of thiurams and carbamates from rubber gloves.

A method for quantitative determination of thiuram and carbamate derivatives released from rubber gloves into synthetic sweat is presented. The analysis was based upon determination of ester derivatives using gas-chromatography/mass spectrometry and isotope-dilution. The detection limit was 0.1 mg thiuram/carbamate in 200 ml synthetic sweat (0.5 ppm). The release of thiurams and carbamates from 5 household and 5 surgical types of gloves into synthetic sweat was determined. Each of the natural rubber gloves released varying amounts of thiurams (0-4.3 mg) as well as carbamates (0-8.1 mg). 22 thiuram-sensitized patients were patch tested with pieces of the gloves. Gloves releasing considerable amounts of thiurams and/or carbamates seemed to cause more positive patch test reactions in these patients than gloves releasing smaller amounts. Surgical gloves made from natural rubber caused a substantial larger number of positive patch test reactions than household gloves made from natural rubber. The amounts released per cm2 of the gloves were of the same order of magnitude as the content per cm2 patch test of thiuram mix, diluted 1:10. The accessibility of a quantitative, chemical analysis for thiurams and carbamates released from rubber gloves makes it reasonable to ask for declarations of rubber gloves. Proposals for threshold values for release of thiurams and carbamates from rubber gloves may be given in the future.

Carbamates↗

PubMed1999

In vivo testing of the protective efficacy of gloves against allergen-containing products using an open chamber system.

In vitro degradation and permeation testing of glove materials is important in the assessment of the protective efficacy against chemicals. In vivo factors, such as skin-glove contact, skin temperature and humidity may, however, influence the protective effect of the glove. These factors must thus be considered in the overall assessment of a protective glove. An in vivo glove test should as far as possible imitate the practical use of the glove, as well as the exposure to the product/chemical against which the glove should protect. An open chamber system for human in vivo glove testing is presented. This system enables simultaneous testing of 6-8 gloves with 3 provocation times for each glove. Positive controls (no glove) can be included. As a control of the subject's present reactivity to the chemical of interest, conventional patch testing with a dilution series can be performed in parallel. The method is easy to use and convenient for the patient. It promises to be a useful clinical tool in individual preventive measures against contact allergy. The method can be used in glove testing against many hazardous chemicals, both contact allergens and toxic/irritant compounds in workplaces such as the plastics industry and the chemical industry.

Allergens↗

PubMed1998

The protective effect of a cut-resistant glove liner. A prospective, randomised trial.

We performed a prospective, randomised study comparing the rates of glove perforation using double latex gloving with or without a disposable protective glove liner (Paraderm) on 118 patients undergoing primary or revision arthroplasty of the hip or knee by one surgeon (FRH). The patients were randomly allocated into two groups: in group 1 an inner and outer pair of latex gloves were worn as double gloves and in group 2 the glove liner was worn between the two latex gloves. There was glove perforation in at least one outer glove in 99 operations (84%). The operating surgeon was aware of the perforation in 21 of these. There were 22 perforations of the inner glove. Group 1 had a significantly higher perforation rate per operation (p < 0.05) than group 2. Our findings show that protective glove liners significantly reduce the rate of perforation of the inner glove during hip and knee arthroplasty.

Arthroplasty, Replacement, Hip↗

PubMed2000

An evaluation of powder-free gloves in general dental practice.

PURPOSE OF STUDY: To evaluate the suitability of two non-sterile, powder-free gloves for routine use in general dental practice. BASIC PROCEDURES: Randomly allocated blind evaluation of two powder-free gloves by five dentists and five dental nurses in general dental practice. Each dentist and dental nurse were allocated a four-day supply of two unnamed powder-free gloves. Following glove usage a questionnaire sought their views regarding ease of donning, operator comfort, puncture and tear resistance, and tactile sensitivity. Details of procedure undertaken, time of wear and puncture and tear formation for the dentists' gloves were also recorded. The dentists' gloves were retained and subsequently tested for punctures and tears. MAIN FINDINGS: In terms of ease of donning, operator discomfort, tear resistance and tactile sensitivity neither glove was ideal, however one glove was rated higher than the other. Overall, the dentists noticed only half of the punctures and tears detected in the laboratory. One glove was more prone to punctures with the other glove more liable to tear. Time worn in excess of 20 minutes and endodontic procedures were associated with a higher incidence of punctures. PRINCIPAL CONCLUSIONS: The two powder-free gloves evaluated in this study would appear not to be suitable for routine use in general dental practice. Further developments are required before powder-free gloves of the type evaluated can be expected to receive widespread acceptance for routine use by dentists and dental nurses in general dental practice.

Chi-Square Distribution↗

PubMed1988

The setting of vinyl polysiloxane and condensation silicone putties when mixed with gloved hands.

Neither the vinyl nor the latex gloves tested affected any of the condensation silicone putties tested. The vinyl gloves tested had no effect on any of the vinyl polysiloxane putties. Some brands of latex gloves as received from the distributor caused severe retardation or complete inhibition of setting in most vinyl polysiloxane putties; other brands of latex gloves affected the setting in the vinyl polysiloxane putties to varying degrees. Washing the latex gloves decreased the effect of inhibition of setting on the putty but did not eliminate it. Thus, latex gloves should not be worn while mixing or handling vinyl polysiloxane putties. Putties should not be dispensed while wearing latex gloves as the entire jar can become contaminated. If gloves are removed to mix the putty, hands should be washed thoroughly; however, this violates the barrier technique and is not recommended. Vinyl gloves may be worn over latex gloves (or by themselves), for dispensing and mixing the putty; but the vinyl gloves should not be contaminated with powder from the latex gloves. To assure compatibility, the putty/glove combination should always be checked.

Chemical Phenomena↗

PubMed1993

[Incidence of hand eczema after surgical washing and use of surgical gloves].

Contact dermatitis caused by surgical gloves is well known. Contact urticaria and anaphylactoid reactions among hospital personnel and patients following contact with latex gloves and glove dusting powder have previously been reported. A suspected increased frequency of hand eczema among personnel using detergents and surgical gloves in operating units initiated the present study. A questionnaire survey was performed in order to examine the frequency and degree of hand eczema among 332 surgeons and nurses working at the surgical units of Odense University Hospital during the period 1.6.-1.9.1989. A total of 242 persons (72%) answered the questionnaire. One hundred and fourteen persons (47%) claimed to develop skin discomfort or hand eczema following the washing procedure or use of surgical gloves. Among the personnel with skin problems 60% had spontaneously changed to another detergent/glove-product with subsequent clearing of the symptoms in 75% of the cases. Dermatological examination and patch tests were performed with European Standard series, gloves, rubber chemicals and selected soap components in 53 persons. Hand eczema was found in 16 persons (7%). Positive patch test reactions to latex gloves were found in four persons and only one person reacted to the rubber accelerators known to be present in the gloves according to the manufacturers' information. Among 26 persons with skin-discomfort and immediate symptoms, ten were prick tested with the standard battery of inhalant allergens, corn starch surgical glove powder, and extract of surgical gloves. Three persons reacted to glove extract, none reacted to glove powder.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1997

Glove failure: an occupational hazard of surgeons in a developing country.

Financial constraints necessitate the reuse of gloves after autoclaving in Sri Lanka. The incidence of glove failure following elective surgery for gynaecological malignancies was studied. Punctures were located by filling gloves with water. The perforation rate was 194/654 (29.6%). Coincidentally, well-fitting gloves were unavailable during part of the study. The puncture rate was significantly higher (P < 0.01) during this period. Defects were found in 12.75% of gloves prepared for reuse. The rate of perforations per operation was 72/88 (81.8%). This increased to 32/32 (100%) when ill-fitting gloves were used, compared with 40/56 (71%) when the proper sizes was available. 6% of new gloves had punctures. In 29 (14.9%) instances the surgical team was aware of glove failure. Factors contributing to glove fragility were: purchase of inferior quality gloves; reuse; shortage of appropriate glove sizes; and imprecision of the test for perforations prior to autoclaving. Health administrators in developing countries should purchase good-quality disposable gloves, and replenish stocks in time.

Accidents, Occupational↗

PubMed2003

Prevention of latex allergy among health care workers: evaluation of the extractable latex protein content in different types of medical gloves.

BACKGROUND: Since the 1980s, there has been increased use of latex gloves by health care workers and a concomitant increase of irritant and allergic reactions. The total protein content and the latex allergenic protein content in different types of medical gloves commonly used in our hospital were evaluated to acquire information useful for preventing latex allergy in our hospital personnel. METHODS: The total protein content and the allergic latex protein contents were evaluated with Lowry modified method and RAST inhibition assay in samples and extracts of 29 different types of medical gloves. RESULTS: The highest concentrations of total proteins and allergenic latex proteins were found in examination powdered latex gloves and in surgical powdered latex gloves; a significant amount of latex proteins was found in some brands of nitrile gloves. CONCLUSIONS: The clear association between the total protein levels and the allergenic latex protein levels suggests that the gloves with highest total protein content have the greatest allergenic potential. Therefore, it is recommended that manufacturing companies should provide package inserts including the total protein contents and possibly allergenic latex protein levels. They should declare whether they have added latex to their nitrile glove formulation. RAST-inhibition assays directly on glove samples instead of glove extract seems to be a good reliable and faster alternative for the evaluation of the allergenic potential of latex gloves.

Allergens↗

PubMed2003

Virus-inhibiting surgical glove to reduce the risk of infection by enveloped viruses.

Needle puncture and other accidents that occur during surgery and other procedures may lead to viral infections of medical personnel, notably by hepatitis C (HCV) and human immunodeficiency virus (HIV), now that hepatitis B can be prevented by vaccination. A new surgical glove called G-VIR, which contains a disinfecting agent for enveloped viruses, has been developed. Herpes simplex type 1 (HSV) was used as a standard enveloped virus in both in vitro and in vivo tests of the virucidal capacity of the glove. Bovine viral diarrhea virus (BVDV) and feline immunodeficiency virus (FIV) were used as models for HCV and HIV, respectively. For in vitro study, a contaminated needle was passed through a glove and residual virus was titrated; for in vivo studies, animals were stuck with a contaminated needle through a glove. Despite variation in virus enumeration inherent in the puncture technique, statistical evaluation showed that infection was reproducibly and substantially reduced by passage through the virucidal layer. For BVDV, the amount of virus passing through the virucidal glove was reduced in 82% of pairwise comparisons with control gloves that lacked the virucidal agent; when plaque counts were adjusted to a common dilution, the median count for the virucidal glove was on the average reduced >10-fold. In experiments in which the proportion of wells infected with FIV was measured, the ratio of TCID(50) values (control glove to G-VIR) was >15, and probably much higher. For HSV, the amount of virus passing through the virucidal glove was reduced in 81% of comparisons with control gloves; the median of adjusted plaque counts was reduced on the average approximately eightfold or ninefold. In vivo tests with FIV and HSV in cats and mice, respectively, found smaller percentage reductions in infection than the in vitro tests but confirmed the virucidal effect of the gloves.

Animals↗

PubMed2004

Risk of glove perforation in minor and major plastic surgery procedures.

BACKGROUND: Incidental needlestick injury with exposure of blood pathogens has a high incidence among health care workers. Because plastic surgeons make up an important risk group for this type of accident, this study sought to evaluate the incidence of glove perforation during minor and major plastic surgery procedures. METHODS: Evidence of glove perforation was evaluated for 390 gloves after 100 consecutive minor surgical procedures and for 710 gloves after 100 consecutive major surgeries using Maffuli's test. An index based on the number of first assistant's glove perforation and the surgical time was created to compare these accidents associated with both types of procedures. RESULTS: Glove perforations were found in four gloves (1.02%) after minor surgery and 76 gloves (21.40%) after major surgery. During minor surgeries, the assistant was more likely to have exposure than the surgeon. During major surgery, the surgeon experienced more glove perforations (59.21%) than the assistant (40.79%). The most common location of perforations was the palmar face of the left hand in both groups. The surgeons did not notice these perforations at any time. The duration of the minor procedures varied from 10 to 30 min (average, 17.55 min), whereas the time of major procedures ranged from 1 to 6 h (average, 186 min). There was no statistical significant difference in the perforation's index between minor and major procedures. CONCLUSIONS: The risk of perforation to the surgeon's glove during minor surgery is minimal. The frequency of perforation to the first assistant's glove is similar between minor and major plastic surgery procedures.

Brazil↗

PubMed2004

Sterile versus nonsterile gloves for repair of uncomplicated lacerations in the emergency department: a randomized controlled trial.

STUDY OBJECTIVE: Although sterile technique for laceration management continues to be recommended, studies supporting this practice are lacking. Using clean nonsterile gloves rather than individually packaged sterile gloves for uncomplicated wound repair in the emergency department may result in cost and time savings. This study is designed to determine whether the rate of infection after repair of uncomplicated lacerations in immunocompetent patients is comparable using clean nonsterile gloves versus sterile gloves. METHODS: A prospective multicenter trial enrolled 816 individuals who were randomized to have their wounds repaired by using sterile or clean nonsterile gloves. The attending physician or resident completed a checklist describing patient, wound, and management characteristics. The patients were provided with a questionnaire to be completed by the physician who removed their sutures at the prescribed time and indicated the presence or absence of infection. When follow-up forms were not returned, a telephone call was made to the patient to determine whether he or she had experienced any wound complications. RESULTS: Follow-up was obtained for 98% of the sterile gloves group and 96.6% of the clean gloves group. There was no statistically significant difference in the incidence of infection between the 2 groups. The infection rate in the sterile gloves group was 6.1% (95% confidence interval [CI] 3.8% to 8.4%) and was 4.4% in the clean gloves group (95% CI 2.4% to 6.4%). The relative risk of infection was 1.37 (95% CI 0.75 to 2.52). CONCLUSION: This study demonstrated that there is no clinically important difference in infection rates between using clean nonsterile gloves and sterile gloves during the repair of uncomplicated traumatic lacerations.

Adult↗