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At least 217 records · Page 12Linked to original sources
PubMed2004

[Double gloving in reducing the interoperative risk of blood borne pathogens].

The potential for blood contact with skin puts operating room personnel at increased risk of exposure to hepatitis or HIV virus. One of the most common areas of contamination with infectious biological material is the hands and fingers due to failure of glove protection. There are varying opinions regarding the frequency of glove failure during orthopaedic procedures and the necessity of wearing two gloves for added protection. The authors performed a trial of 94 procedures involving 10 surgeons from Orthopaedic Department of Pomeranian Medical University from Szczecin, Poland to answer these questions. Outer-glove perforations occurred in 15% of the cases while inner-glove--in only 3.1% (p < 0.0001). In 5 cases there was an inner-glove defect without a corresponding outer-glove perforation. Both the duration of the operation longer than 2 hours and the type of the procedure (minor versus major) were associated with increased rates of perforation (p < 0.002 and p < 0.0007 respectively). From total amount of perforated outer-gloves, only 13 (28%) were changed by the surgeon during the operation. There was no statistically significant difference between latex and neoprene used as inner-gloves (p > 0.17) in failure rates. The authors conclude double gloving during orthopaedic procedures and changing the gloves every 2 hours may significantly reduce the operating room personnel's risk of exposure to blood borne pathogens.

Blood-Borne Pathogens↗
PubMedDate not supplied

Comparative study: the effects of latex and vinyl gloves on the tactile discrimination of first year dental hygiene students.

The purposes of this study were to determine 1) if there was a significant difference in the tactile discrimination of first year dental hygiene students wearing a vinyl glove as compared to a latex glove; 2) if the subjects' perceptions of their ability to accurately discriminate between surface textures differed when wearing either one of the two gloves; and 3) the individual characteristics of the gloves preferred by the subjects. Twenty-nine first year dental students were randomly assigned to one of the two glove treatment groups. The tactile discrimination ability of each subject was assessed at baseline and three weeks after using the Roughness Discrimination Test (RDT). The subjects wore their assigned gloves when performing laboratory and clinical procedures during the 3-week period. Following this period the RDT was again administered. Subjects then switched gloves for an additional 3-week period, at which time data were collected regarding perceived discrimination ability and glove preference. Data were analyzed using a repeated-measures analysis of variance. Results revealed no significant difference (p less than 0.05) in subject's tactile discrimination ability while 29% indicated that the latex glove had an inhibitory effect. The subjects most frequently preferred the latex glove, citing specific favorable characteristics such as size, fit, comfort and durability while performing clinical procedures. However, the vinyl glove was favored for durability after washing.

Gloves, Surgical↗
PubMedDate not supplied

Perforation and proteinaceous contamination of dental gloves during prosthodontic treatments.

The effect of the type of prosthodontic treatment on glove perforation and proteinaceous contamination of gloves was investigated for 364 prosthodontic treatments using poly(vinyl chloride) plastic (218 occasions) and latex gloves (146 occasions). The amount of protein contamination on plastic or latex gloves varied depending on the prosthodontic treatment performed and the patient treated. As determined directly, it averaged from approximately 800 to 1,500 micrograms per treatment, and the maximum value of protein contamination was more than 4,000 micrograms, corresponding to the amount of protein in 1.5 mL of saliva or 0.1 mL of serum. The perforation of plastic gloves was observed in 83.0% of the total occasions, and the perforation went unrecognized 96.1% of the time. In contrast, the proportion of glove perforation for latex gloves was 12.3% and the proportion of unrecognized perforation of latex gloves was 5.4%. The results suggest that latex gloves are effective in reducing the risk of cross-infection. Nevertheless, prosthodontists still have a potential risk of being exposed to bodily fluids, without being aware of glove perforation, at least once in every 20 treatments, even if latex gloves are worn.

Blood Proteins↗
PubMed1994

Allergen and protein content of latex gloves.

BACKGROUND: Proteins eluting from surgical gloves and other medical rubber products elicit immediate local and systemic hypersensitivity reactions in latex-allergic subjects but detailed knowledge about the amount and allergenic potential of these proteins is scanty. OBJECTIVE: To protect latex-allergic people and to diminish the risk of sensitization, adequate methods are needed to measure and monitor the allergen content of surgical latex gloves. METHODS: Extracts of six surgical and one household latex glove brand were studied. Bradford and Lowry methods were used for total protein measurements. Sera from 17 latex-allergic patients were used as a source of latex IgE antibodies. Allergen content of extracts was studied in vitro by immunoblot, crossed radioimmunoelectrophoresis and immunospot methods, and in vivo by skin prick testing in 35 latex-allergic patients. RESULTS: The total protein concentration of the glove extracts varied from 3 to 337 micrograms/g glove. The Bradford method gave lower values than the Lowry method. Immunoblotting showed allergenic rubber proteins in four of the seven glove brands. Ten proteins in two surgical and six proteins in one household glove brand bound latex IgE antibodies in a heterogeneous manner. The results from crossed radioimmunoelectrophoresis and immunospot assays were mostly in line with immunoblotting findings. Extracts from five of the seven glove brands elicited positive prick tests; in all five also the presence of allergens could be shown by in vitro tests. Prick test reactivity and total protein concentration were not directly correlated. CONCLUSIONS: In vitro assays showed considerable variation in the total protein and allergen contents of different latex glove brands. The amount of protein eluting from the gloves did not always correlate with their allergenicity in skin prick tests indicating that total protein measurement is not a sufficient method to monitor the allergenic properties of latex gloves.

Allergens↗
PubMed1997

Double gloving as self protection in abdominal surgery.

OBJECTIVE: To investigate if double gloving can reduce the rate of perforation of glove barriers during abdominal surgery. DESIGN: Randomised controlled trial. SETTING: County hospital, Denmark. SUBJECTS: 400 glove barriers from principal surgeons and first assistants used at consecutive abdominal operations. INTERVENTION: Each participant was randomised to wear either a pair of single or double gloves. MAIN OUTCOME MEASURES: The number of perforated glove barriers in the two study groups. RESULTS: 40 single glove barriers perforated (20%) and in 8 of the double glove group both gloves perforated (4%) (p < 0.001). Glove barriers on non-dominant hands were more often perforated than those on dominant hands, and both the duration of the operation and the seniority of the doctor were associated with increased rates of perforation. CONCLUSION: Double gloving reduces the rate of perforation of glove barriers during abdominal surgery and thereby the number of episodes in which transmission of disease from patient to surgeon would be possible.

Abdomen↗
PubMed1997

Barrier durability of latex and vinyl medical gloves in clinical settings.

This study evaluated changes in the tensile strength and barrier integrity of medical gloves during hospital clinical use. Nonsterile vinyl, sterile vinyl, and nonsterile natural rubber latex gloves were collected after use in a clinical setting and then tested for tensile strength, elongation, and water leakage. Tensile properties of vinyl gloves did not change during use, whereas changes in latex depended on the brand evaluated. New gloves, regardless of material of manufacture, were found to have leakage rates of 2% or less. Two brands of nonsterile vinyl gloves were found to have an average rate of leakage after use of 24 to 28% (average 26%), three brands of latex gloves of 6 to 10% (average 8%), and one brand of sterile vinyl gloves of 3%. Low-protein powderless latex gloves leaked slightly less than the powdered brands. The high rates of leakage observed for nonsterile vinyl gloves indicate that they provide less barrier protection than latex in typical hospital use. The low leakage rate observed for sterile vinyl gloves indicates that barrier durability is not solely a function of the generic polymer composition of the barrier.

Equipment Failure↗
PubMed1993

Unsuspected glove perforation during ophthalmic surgery.

OBJECTIVES: To determine the rate of perforation of surgical gloves after ophthalmic surgery and to identify factors that contribute to the development of perforations. DESIGN: Case-control study of used and unused surgical gloves collected during a 7-month period. SETTING: The ophthalmology surgical suites of a major teaching hospital. MAIN OUTCOME MEASURES: Development of glove perforations as measured by five different techniques. RESULTS: We tested 103 pairs of latex surgical gloves before use and 454 pairs of gloves after use. Of five techniques used to test for pinholes, air inflation with water submersion and compression was found to be the most sensitive, yielding a 6.80% prevalence in control glove pairs and a 21.81% prevalence in study glove pairs (P = .0005). When examined by subspecialty area, the lowest perforation rate (11.39%; P = .00009) occurred in cataract and intraocular lens surgery and the highest rate (41.67%; P = .003) occurred in oculoplastic surgery. Factors that correlated significantly with the development of perforations as determined by multiple logistic regression analysis included pediatric ophthalmology and strabismus surgeries, oculoplastic surgeries, level of training of the surgeon, duration of operation, and larger glove size. The thumb and index fingers of the nondominant hand contained the largest numbers of pinholes. CONCLUSIONS: The rate of surgical glove perforation after ophthalmic surgery is relatively high. Recommendations for reducing the rate of glove perforation are discussed.

Case-Control Studies↗
PubMed1996

Studies of determinants of glove hole puncture during electrosurgery.

Holes in surgical gloves are considered to be an important source of transmission of pathogens between patient and surgeon. The purpose of this study was to determine if electrosurgery could alter the integrity of latex surgical gloves. The effects of electrosurgery on 11 brands of commercially available latex surgical gloves were tested through an in vitro study that simulated the conditions in the operating room. Glove hole puncture was encountered only with coagulation current operating at the highest setting. In addition, maximal surface area contact with the hemostat to the glove surface was required to produce glove puncture. The presence of powder and glove hydration were not significant determinants of glove hole puncture. On the basis of our study, we believe that all surgical gloves tested offered the surgeon adequate protection at commonly used levels of cutting and coagulation current, as long as no breach existed prior to the donning of gloves.

Electrosurgery↗
PubMedDate not supplied

Use of surgical pass trays to reduce intraoperative glove perforations.

This randomized prospective study evaluated the surgical pass tray to reduce intraoperative glove perforation during cesarean delivery. Surgical team members were assigned to employ normal instrument pass techniques or surgical pass tray during all cesarean deliveries. Surgical team members were asked to record their surgical role and level of training. Gloves were collected and tested using standard hydrosufflation techniques. Additional variables studied were patient weight, surgical indication, estimated blood loss, and length of surgery. A total of 192 cesarean sections were performed during the study period, for which 165 were studied. Data collection was considered adequate in 156 cases. Four hundred forty-four pairs of gloves were collected and tested, including 38 double glove sets. Seventy-eight perforations were noted in 444 pairs of gloves, including 11 in the double glove sets. Among surgeries assigned to use pass trays, 221 pairs of gloves were obtained with 42 (19.0%) perforations noted. Surgeries assigned to the control group contributed 223 glove sets of which 36 (16.1%) perforations were noted (P = .5). There were no complete perforations noted in the total of double glove sets. The frequency of glove perforations is not reduced by using surgical pass trays. While there is no demonstrated benefit in using pass trays there appears to be little adverse impact.

Cesarean Section↗
PubMedDate not supplied

Effects of placental delivery method and intraoperative glove changing on postcesarean febrile morbidity.

This study was designed to evaluate the effects of the placental delivery methods and intraoperative glove changing on postcesarean febrile morbidity. In this randomized controlled trial, consenting patients were randomized to one of four management protocols: Group A (n = 26)--no glove change with manual placental delivery; Group B (n = 27)--no glove change with expressed placental delivery; Group C (n = 27)--glove change with manual placental delivery; and Group D (n = 28)--glove change with expressed placental delivery. Glove change was performed by removal of a second glove after delivery of the fetal head. Variables examined included febrile morbidity, endometritis, maximums and durations of elevated temperatures, as well as other demographic, intrapartum, and postpartum variables. Febrile morbidity and endometritis rates were not significantly different between the four groups. When the groups were combined so as to compare no glove change versus glove change (Groups A and B vs. C and D) and manual versus expressed placental delivery (Groups A and C vs. B and D), there were no significant differences in either febrile morbidity (relative risk: 0.7, 95% CI: 0.3-1.4 and relative risk: 1.4, 95% CI: 0.6-3.5) or endometritis (relative risk: 1.2, 95% CI: 0.5-2.8 and relative risk: 1.5, 95% CI: 0.6-3.6), respectively. There were no statistically significant differences in measures of postcesarean febrile morbidity based on placental delivery method or intraoperative glove change.

Cesarean Section↗
PubMed2003

Glove punctures in orthopaedic surgery.

From February 2001 to May 2001, 792 latex gloves used in 100 operations from three orthopaedic sub-specialties (paediatrics, hand and spine) were tested for puncture by a water infusion test. Sixty-nine gloves from 45 operations were punctured, giving an overall glove perforation rate of 8.7% (69/792) and an operative perforation rate of 45% (45/100). The hand operations had the lowest operative perforation rate (19.4%) while the spine operations had the highest (63.6%). The glove perforation rate increased in bony procedures (60% versus 22.5%), in procedures with major instrumentation (66% versus 18%) and in more lengthy procedures. The thumbs and the left index finger had more punctures than other parts. In addition, the glove perforation rate for single gloving was 9.6% (53/552) while that for the inner glove of double gloving was 0.8% (1/120). Based on these findings, we would like to recommend double gloving and regular glove changing in these high-risk surgeries.

Equipment Failure↗
PubMed1990

Prospective, controlled study of vinyl glove use to interrupt Clostridium difficile nosocomial transmission.

PURPOSE: Despite recognition that Clostridium difficile diarrhea/colitis is a nosocomial infection, the manner in which this organism is transmitted is still not clear. Hands of health care workers have been shown to be contaminated with C. difficile and suggested as a vehicle of transmission. Therefore, we conducted a controlled trial of the use of disposable vinyl gloves by hospital personnel for all body substance contact (prior to the institution of universal body substance precautions) to study its effect on the incidence of C. difficile disease. PATIENTS AND METHODS: The incidence of nosocomial C. difficile diarrhea was monitored by active surveillance for six months before and after an intensive education program regarding glove use on two hospital wards. The interventions included initial and periodic in-services, posters, and placement of boxes of gloves at every patient's bedside. Two comparable wards where no special intervention was instituted served as controls. RESULTS: A decrease in the incidence of C. difficile diarrhea from 7.7 cases/1,000 patient discharges during the six months before intervention to 1.5/1,000 during the six months of intervention on the glove wards was observed (p = 0.015). No significant change in incidence was observed on the two control wards during the same period (5.7/1,000 versus 4.2/1,000). Point prevalence of asymptomatic C. difficile carriage was also reduced significantly on the glove wards but not on the control wards after the intervention period (glove wards, 10 of 37 to four of 43, p = 0.029; control wards, five of 30 to five of 49, p = 0.19). The cost of 61,500 gloves (4,505 gloves/100 patients) used was $2,768 on the glove wards, compared with $1,895 (42,100 gloves; 3,532 gloves/100 patients) on the control wards. CONCLUSIONS: Vinyl glove use was associated with a reduced incidence of C. difficile diarrhea and is indirect evidence for hand carriage as a means of nosocomial C. difficile spread.

Clostridioides difficile↗
PubMed1993

Surgical glove punctures during cardiac operations.

A new method of detecting occult glove punctures was devised to determine its frequency during cardiac operations. Glove puncture is of relevance to the transmission of infectious diseases and the potential contamination of implanted cardiac prostheses. A study was therefore carried out in 48 adult patients undergoing open heart operations in which gloves worn by surgeons and nurses were collected and evaluated at the end of each procedure. In 22 of these cases, gloves were changed at three different stages of the cardiac operation for the principal operators: stage I, skin incision to commencement of cardiopulmonary bypass; stage II, cardiopulmonary bypass to sternotomy closure; and stage III, sternotomy closure to skin closure. One hundred sixty-two gloves (31.5%) had one or more punctures out of a total of 514 gloves tested. Only 20 glove punctures were recognized either at the time or at the end of the operation. There were 185 occult glove punctures. The majority (60%) of punctures were on the nondominant hand, with 30% of perforations located in the nondominant index finger. Using the chi 2 test with two degrees of freedom, there is no significant difference between the glove perforation rates for the principal operators in stages I, II, and III. The most important finding from this study was that 61% of gloves worn by scrub nurses had one or more punctures compared with 23.6% of surgeons.

Cardiac Surgical Procedures↗
PubMed1992

A clinical evaluation of glove washing and re-use in dental practice.

This study has assessed the durability of four brands of latex gloves, Ansell Medical 'Medi-Grip', Regent 'Biogel D', Surgikos 'Microtouch' and the London Rubber Company 'Supreme', under conditions of repeated washing and re-use in a clinical dental setting. The microbiological effectiveness of 'Hibiscrub' as a decontaminating washing agent was examined simultaneously. Examination by an electrical test for micropunctures in 200 unused gloves of each brand revealed such defects in 6(3%) of Ansell 'Medi-Grip', 3(1.5%) of 'Biogel D', 14(7%) of Surgikos 'Microtouch' and 2(1%) of LRC 'Supreme' gloves. Following repeated clinical use, micropunctures were detected in 18% of Ansell 'Medi-Grip', 10% of 'Biogel D', 75% of Surgikos 'Microtouch' and 56% of LRC 'Supreme'. Microorganisms were isolated from the glove surfaces after 45% of the occasions on which the gloves were washed for 1 min in 'Hibiscrub' (ICI Dental). Eighty-five per cent of these isolates were environmental organisms, but oral streptococci were isolated from 8.4% of the pairs of gloves examined. The high rate of micropuncture development following repeated washing and re-use of latex gloves indicates that they cannot effectively perform their barrier function under such conditions. The microbiological data have also revealed the potential for cross-infection between patients through inadequate decontamination of glove surfaces. For operative dental surgery, the results suggest that heavier, surgical type gloves are to be preferred, and that multiple use of any glove type should be discouraged.

Bacteriological Techniques↗
PubMedDate not supplied

A new glove puncture detection system.

A new glove detection system has been developed for early and accurate detection of a hole in the glove. It consists of an inner glove colored by a green dye and outer glove. When a breach in the outer glove occurs, the inner glove develops a dark patch around the needle puncture hole, a visible indicator for immediate glove change. Using a computerized needle penetration system, the immediate and maximal penetration forces as well as the work required for needle penetration of this new double glove was significantly greater than those encountered with either the inner or outer glove tested separately. In addition to hole detection, this double glove provides increased protection against needle penetration.

Coloring Agents↗
PubMed2006

The effects of glove thickness and work load on female hand performance and fatigue during a infrequent high-intensity gripping task.

In various workplaces, gloves are commonly employed to protect the hands with the design rationale of 'the thicker the gloves, the better the protection'. Therefore, the present paper investigated the effects of glove thickness on hand performance and fatigue during two infrequent high-intensity gripping tasks, such as 5-s and sustained tasks. The hand performance was evaluated by maximum volitional contraction (MVC) and its associated time needed to reach the MVC (TMVC), and the total force generation (TFG) during the sustained task. The hand fatigue was assessed by MVC degeneration (DeltaMVC), the shift in time needed to reach the MVC (DeltaTMVC), and the maximal endurance time (MET) associated with the sustained task. Ten female subjects took part in the experiment voluntarily. The four-gloved conditions included bare hand, wearing one layer (Cotton-1), wearing two layers of cotton gloves (Cotton-2), and covering the handle with two layers of cotton glove and exerting with the bare hand (Covered-2). The results indicates that wearing gloves decreased the grip MVC, and the thicker the gloves, the less the grip MVC, but the wearing style did not change the MVC (Cotton-2 MVC was indifferent from Covered-2 MVC). As to muscular fatigue, on the other hand, wearing gloves did not affect DeltaMVC, MET, TMVC, or DeltaTMVC. Due to the greater bare-hand MVC and indifferent MET, bare-hand TFG was better than those conditions with gloves. Finally, the load specified here did not alter TMVC or DeltaTMVC, but the greater the load, the more strength degeneration (DeltaMVC) was induced.

Adult↗
PubMed1999

Cow's milk casein, a hidden allergen in natural rubber latex gloves.

BACKGROUND: We have previously noted that one natural rubber latex (NRL) glove brand used for skin prick testing in the diagnosis of NRL allergy contained cow's milk casein. OBJECTIVE: We sought to examine whether other commonly marketed NRL glove brands contain cow's milk casein. METHODS: The casein content of 30 NRL glove extracts (1:5 wt/vol) was measured by RAST inhibition and by rocket immunoelectrophoresis and rocket radioimmunoelectrophoresis by using casein-specific rabbit antiserum, a serum pool from patients with cow's milk allergy, and radiolabeled anti-human IgE. The NRL allergen content was measured by ELISA inhibition. RESULTS: The casein content of the glove used in NRL allergy screening (Triflex, Baxter) was rather high (ie, about 400 microgram/g of glove). Its total protein content was 1000 microgram/g of glove. Rocket radioimmunoelectrophoresis detected distinct amounts of casein in 8, minimal amounts in 7, and no casein in the remaining 15 NRL glove brands. CONCLUSIONS: Several brands of NRL gloves were found to contain casein, implying that extracts prepared from such gloves can cause false-positive skin prick test reactions when diagnosing NRL allergy. The use of casein as a stabilizer in glove manufacture without appropriate labeling should be stopped because it can also cause contact urticaria syndrome in individuals with cow's milk allergy.

Allergens↗
PubMed2000

The permeability of dental procedure and examination gloves by an alcohol based disinfectant.

OBJECTIVES: The usage of gloves in dentistry has increased greatly over the last 10 years and this has highlighted certain problems when gloves are being worn extensively. While skin irritations and allergies caused by latex proteins and accelerators have been the main focus of attention, dental materials such as disinfectants have also become known as a source of skin reactions. This study was performed to evaluate the permeability of various gloves by ethanol. METHODS: The tip of the middle finger of 13 glove brands (natural latex gloves (NLG) powdered or unpowdered, powdered vinyl, nitrile and synthetic elastomer) was exposed to 5 ml of a hand disinfectant (Desderman). After a penetration time ranging from 2 min to 8 h the permeation of Desderman was detected with a gas chromatograph. RESULTS: Only one component of the disinfectant (ethanol) could be detected to have gone through the gloves. After only 2 min the vinyl and one nitrile glove and after 10 min all glove types were permeated. Powder seemed to have no real influence on the penetration of ethanol. Some natural latex gloves showed a low rate of leakage, while vinyl and nitrile gloves were penetrated quickly and to a great extent. The synthetic elastomer (Biogel Neotech) was the only one with a significantly lower penetration even after 2-8 h. SIGNIFICANCE: While there are reports of adverse skin reactions to alcohol the amount of ethanol (up to 40 microliters after 2 h) detected in this study is much too low to cause irritations and certainly not toxicity, but it could possibly initiate allergic reactions.

Analysis of Variance↗