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PubMedDate not supplied

Use of double gloves to protect the surgeon from blood contact during aesthetic procedures.

The potential for blood contact with nonintact skin puts operating room personnel at an increased risk of exposure to hepatitis or HIV virus. Frank needle-stick injury to the surgeon has been shown to occur once every 20-40 operations. It has been shown that blood contact exposure during aesthetic surgery occurs in 32% of the operations in which a single pair of surgical gloves is used (surgeon 39.7%, assistant 23%). The reduction of blood contact exposure during aesthetic surgical procedures by using two pairs of gloves was tested and demonstrated. Contact rates decreased by 70%. Outer-glove perforations occurred in 25.6% of the cases, while inner-glove perforations occurred in only 10% of the cases (surgeon 8.7%, assistant 3.5%). All of the inner-glove perforations occurred during procedures that lasted longer than two hours, and in no case was there an inner-glove defect without a corresponding outer-glove perforation. The nondominant index finger (33%) was the most common location. Double gloving during aesthetic procedures reduced the operating room personnel's risk of blood contact exposure by 70% when compared with single-glove use.

Blood-Borne Pathogens↗
PubMed2002

Glove powder in the hospital environment -- consequences for healthcare workers.

OBJECTIVE: Exposure to starch powder from natural rubber latex medical gloves can cause allergy symptoms among healthcare employees and impair working conditions, due to the absorption of latex protein antigens onto the starch powder on the gloves. To evaluate and take care of this problem at Stockholm Söder Hospital we carried out this study. METHODS: A questionnaire was distributed to all employees working within the medical centre. The procedure was repeated after the centre had been changed to a powder-free working environment. The focus of the questions was to determine the extent of symptoms that could be associated with glove powder or latex proteins. RESULTS: Responses were compared before and 8 months after a new powder-free glove policy was fully implemented. The study pointed out that a relatively high percentage of the hospital workers were suffering from glove-related symptoms. A significant reduction of itching on the hands, hand eczema and upper respiratory-tract disorders was found after the change to a powder-free environment. CONCLUSION: It is not acceptable to use powdered medical gloves within health care. In spite of the risk of allergy and impairment of the working environment from powdered gloves, there is still only a minority of hospitals working according to a strict general powder-free policy. This study has pointed out that the reduced cost resulting from reduced absence through sickness further adds an argument for omitting glove powder and can justify the higher cost of using powder-free medical gloves.

Dermatitis, Allergic Contact↗
PubMed1991

The effect of disinfectants on perforated gloves.

Three types of gloves, 'Biogel', 'Regent Dispo Surgical' gloves and Ansell gammex were perforated, and contaminated with Escherichia coli or Pseudomonas aeruginosa as test organisms applied either to the hand or the glove surface. The glove surface was decontaminated with alcoholic chlorhexidine ('Hibisol'), methylated spirit, or soap and water. The experiments were performed in triplicate on three separate days. The experiments were designed to study the ability of the three disinfection methods to reduce the bacterial count of 10(6) colony forming units (cfu) ml-1 (applied to perforated gloves or hands) sufficiently to permit the re-use of such gloves for non-sterile ward procedures. The best method of disinfection was using alcoholic chlorhexidine which not only reduced glove surface carriage but also reduced transfer of bacteria to the hands through the perforation in the gloves. Soap and water was the least effective. Escherichia coli was more easily removed than P. aeruginosa. We recommend that non-sterile ward procedures may be carried out even after gloves have been perforated provided alcoholic chlorhexidine is used between each procedure to reduce cross-infection between patients.

Chlorhexidine↗
PubMed1989

Permeability of latex and vinyl gloves to water and blood.

Two thousand four hundred medical gloves were evaluated for leakage. Types of gloves examined (number of brands) included sterile latex (seven) sterile vinyl (four), nonsterile latex (six), and nonsterile vinyl (seven). Sampling was done from one box of each brand. Fifty gloves from each box were filled with 300 ml of water (the standard test used by the American Society for Testing and Materials). An additional 25 cm pressure was applied to water-filled gloves. Another 50 gloves of each box were donned and dipped into a basin that contained heparinized human blood. Only four brands of sterile latex surgeon's gloves proved nonpermeable to water and blood. Other brands showed leakage that ranged from 1% to 52%. Analysis of proportions of pairs of gloves permeable to water or blood indicated a strong statistical association of nonsterile packaging or packaging in suction kits with increased leakage rates. These findings affirm that gloves can be regarded only as a means of reducing the risk of gross soilage from blood or body fluids. Quality control standards to ensure more uniform glove quality are needed.

Blood↗
PubMed2005

Unnoticed glove perforation during thoracoscopic and open thoracic surgery.

BACKGROUND: Surgeons tend to underestimate the risk of transferring infection during thoracoscopic operations, although data on glove perforation in thoracoscopic operations have not been reported. METHODS: Unnoticed perforations of the gloves worn by the same primary surgeon during thoracoscopic procedures and open thoracotomy were studied. Gloves with gross damage and those changed due to assumed damage were excluded. Gloves were tested by filling with water and squeezing to inflate each finger, which could detect a perforation by a 30-gauge needle. RESULTS: Perforation was found in 25% after thoracoscopic operation, although this was significantly lower than 70% after open thoracotomy. Twelve percent of the gloves worn during thoracoscopic operation were perforated. The perforation rate was higher for gloves worn for more than 2 hours during thoracoscopic operation. CONCLUSIONS: Glove perforation occurred without being noticed in 25% of thoracoscopic procedures, and in 12% of the gloves used during the procedure. Glove change within 2 hours is recommended.

Adolescent↗
PubMed2006

Permeation of Comite through protective gloves.

The goal of the study was to assess how protective disposable (Safeskin) and chemical protective (Sol-Vex) nitrile gloves were against Comite emulsifiable concentrate formulation containing propargite (PROP) as active pesticidal ingredient, because there were no explicit recommendations for the gloves that should be worn for hand protection. The glove material was exposed in ASTM-type I-PTC-600 permeation cells at 30.0+/-0.5 degrees C, and gas chromatography-mass spectrometry used for PROP analysis. Aqueous solutions of Comite at 40.4 mg/mL permeated both Safeskin and Sol-Vex nitrile by 8h. Safeskin showed a mean PROP mass permeated of 176+/-27 microg after 8h compared with a mean mass permeated for Sol-Vex of 3.17+/-4.08 microg. Thus, Sol-Vex was about 56 times more protective than Safeskin for an 8-h exposure. However, the kinetics of the permeation revealed that Safeskin can be worn for at least 200 min before disposal. When undiluted Comite challenged both types of nitrile, much faster permeation was observed. Safeskin gloves showed two steady state periods. The first had lag times (t(l)) values of about 1h, although normalized breakthrough times (t(b)) were < 10 min. The second steady state rate (P(s)) was on average four times the rate of the first period, and the second steady state period t(l) was about three times as long as that of the first steady state period, and about the same t(l) as for the aqueous solution. Sol-Vex gloves exposed continuously to undiluted Comite permeated above the normalized breakthrough threshold beyond 2.7h. A risk assessment revealed that the PROP skin permeation rate of 7.1 ng cm(-2)h(-1) was much slower than the first steady state Safeskin glove P(s) of 62,000 ng cm(-2)h(-1). Infrared analysis showed that the glove surfaces were not degraded by the Comite challenge. The chemically protective Sol-Vex gloves protected adequately against undiluted formulation for about 2.7h, whereas they provided protection for nearly 8h when the formulation was diluted with water to the highest concentration for field application. In contrast, the disposable Safeskin gloves did not protect at all for the undiluted formulation, but did for 200 min when the formulation was diluted with water to the highest concentration for spraying.

Chromatography, Gas↗
PubMed2003

A laboratory-based study to assess the performance of surgical gloves.

The inherent tear resistance and elasticity of latex and the touch sensitivity it provides has made it the traditional material of choice for surgical gloves, protecting both health care workers and patients from the transmission of bloodborne infections. Although increased incidence of latex allergy has led to increased use of nonlatex surgical gloves, the effectiveness of these gloves as a barrier to infection has not been examined thoroughly. This laboratory-based study compared the performance of latex and nonlatex surgical gloves in a simulated stress protocol. The propensity of surgical gloves to fail was dependent on glove material, manufacturer, and stress. Nonlatex neoprene and nitrile gloves were comparable to latex and can provide a good alternative to latex for allergic patients and health care workers. In this study, isoprene was found to be inferior to latex and other nonlatex materials. The presence or absence of glove powder had no significant influence on the probability of glove failure.

Butadienes↗
PubMed1988

Assessment of the effectiveness of glove use as a barrier technique in the dental operatory.

To assess the effectiveness of routine glove use as a barrier technique in the dental operatory, the relationship between frequency of glove use and hepatitis B infection was examined. Hepatitis B screening results and information on infection control practices of 1,109 dentists who attended the 1985 annual session were compiled and statistically analyzed. The results showed that 18% of the dentists wore gloves routinely, 65% wore gloves intermittently, and 17% never wore gloves. Frequency of glove use was related to hepatitis B infection (P less than .01), with dentists who never wore gloves being infected more than twice as often as dentists who wore gloves routinely. Dentists with less frequent glove use and more years in practice had a higher incidence of hepatitis B infection (P less than .0001).

Dentists↗
PubMed1996

The use of a surgical assist device to reduce glove perforations in postdelivery vaginal repair: a randomized controlled trial.

OBJECTIVE: Our purpose was to compare the effectiveness of a surgical assist device, SutureMate, to decrease glove perforations during postdelivery vaginal repair. STUDY DESIGN: This was a prospective randomized trial. After delivery surgeons who needed to perform vaginal repair were randomized to use the surgical assist device or to perform the repair in the usual fashion. After the repair, gloves were collected and the operator was asked to complete a standardized data form that was submitted with the gloves. The gloves were tested for perforations within 24 hours by the Food and Drug Administration-approved hydrosufflation technique. Comparisons were made with chi(2) statistics with p < 0.01 taken as being statistically significant with the use of a Bonferoni adjustment for multiple comparisons. RESULTS: A total of 476 glove sets were evaluated. The use of the surgical assist device significantly reduced the overall glove perforation rate from 28.3% in the control arm to 8.4% in the study arm (p = 0.0001). Rates of perforation varied with level of training and expertise but fell in all groups that used the device. Family physicians had the highest perforation rate in the control arm and benefited most from the device. A total of 76% of perforations were located in the thumb, index, and second fingers of the nondominant hand. Perforations were recognized in only 16% of the glove sets. The level of satisfaction with the device was mixed, but overall 50% of operators indicated that they were either satisfied or very satisfied with the device. CONCLUSION: The rate of glove perforation in postdelivery vaginal repair is high. The surgical assist device significantly reduced the rate of glove perforations.

Delivery, Obstetric↗
PubMed1998

Assessing the performance of anti-vibration gloves--a possible alternative to ISO 10819, 1996.

Special gloves (commonly referred to as anti-vibration gloves) have been offered for many years as personal protection against hand-arm vibration generated, for example, by powered hand tools. An internationally agreed means of quantifying the vibration-reducing performance of such gloves was not available until the publication of International Standard ISO 10819, 1996. The evaluation of the Standard reported here has led to the conclusion that the test could be improved to give more information to the potential glove user about how the glove might perform. Investigations of the main factors which can influence the results of glove transmissibility tests have formed the basis for a proposal to develop the Standard. The proposed alternative test measures the performance of a glove in octave bands and the resultant data can be used to estimate the potential that the glove has to protect against any given vibration source. Examples of the application of the proposed alternative test for selection of anti-vibration gloves matched to particular vibration sources (powered hand tools) are given. The advantages and disadvantages of the two test methods are discussed. The evaluation of the Standard and proposals for its development are under discussion with members of the committee which developed ISO 10819, 1996.

Gloves, Protective↗
PubMed2003

Effect of two types of latex gloves and surfactants on polymerization inhibition of three polyvinylsiloxane impression materials.

STATEMENT OF PROBLEM: Polymerization inhibition of polyvinylsiloxane impression materials has been reported when in sustained contact with some types of latex gloves. PURPOSE: This study examined the polymerization inhibition of 3 polyvinylsiloxane impression materials placed in contact with surfaces subjected to prior contact with gloves or commonly used surfactants. MATERIAL AND METHODS: A 2 x 3 x 4 x 2 design was used (n = 20), with 2 types of gloves (powdered and unpowdered), 3 types of polyvinylsiloxane impression materials (Aquasil, Extrude, and Affinis), 4 surfactant conditions (water, soap/water-rinse, alcohol, and unexposed), and 2 ambient temperatures of 22 degrees C and 36 degrees C. After glove exposure to surfactants, a glass surface was subjected to rubbing contact with the treated glove for a standardized time. After drying, automixed polyvinylsiloxane impression materials were dispensed onto the treated surface. Specimens were removed and evaluated for polymerization inhibition at the manufacturer's recommended polymerization time (36 degrees C), or after 15 minutes at 22 degrees C. Specimens were rated as polymerized, or as inhibited if any polyvinylsiloxane residue remained on the slab. A chi-square analysis was used to evaluate the results (alpha=.05). RESULTS: Setting inhibition was found only with one of the polyvinylsiloxane materials when alcohol was used as a surfactant. At 22 degrees C, the inhibition rate ranged from 95% to 100% for both glove types; at 36 degrees C inhibition ranged from 40% (unpowdered gloves) to 75% (powdered gloves), respectively. CONCLUSION: Under these in vitro conditions, glove exposure to alcohol resulted in polymerization inhibition of 1 of 3 tested polyvinylsiloxane impression materials (Extrude).

Alcohols↗
PubMed1993

Permeability of latex gloves after contact with dental materials.

The use of latex examination gloves in the dental office has become the standard of care. However, the effectiveness of gloves as a barrier after coming into contact with specific dental materials is still uncertain. To examine the effects of dental materials is still uncertain. To examine the effects of dental materials on latex, 100 latex examination glove finger tips were divided into 10 groups. Each group was manipulated in a different dental material for 15 minutes. Permeability was detected by the passage of herpes virus across the latex membrane, rinsed from the inner glove surface and titrated onto Vero cells. Significant virus leakage was discovered in gloves treated with acrylic monomer, chloroform, and orange solvent. Little virus leakage was noted in bleach, soap, and 30% phosphoric acid etchant treated gloves, and no virus leakage was found with composite resin, ethanol, formocresol, and water treated gloves. These data were supported with scanning electron micrographs taken of the treated glove samples and comparing with the controls. When certain dental materials are manipulated while wearing gloves, irreversible damage to the material occurs and may increase the practitioner's exposure to pathogens.

Animals↗
PubMed1989

Permeability studies on protective gloves used in dental practice.

The recent guidelines issued by the DHSS and the BDS recommend that to prevent cross-infection gloves should be worn by dentists and their assistants whilst treating all patients. Little information is available on the permeability of the various types of glove available; this pilot study was therefore conducted, to test five commonly used brands of gloves for permeability to air, electrolytes, dye and bacteria. Tests were carried out before and after using the gloves for varying periods. From these studies it was found that only one brand of glove passed all the tests before wearing. After wearing the gloves for up to 3 hours, between 20% and 50% of the gloves, depending on type, allowed bacteria to pass across the glove. The visual test was less critical than the ion passage and bacterial tests, in that some gloves without obvious perforations allowed ions and bacteria to pass through.

Coloring Agents↗
PubMed1989

The use of various handwashing agents to decontaminate gloved hands.

It has been suggested that gloved hands could be washed between patient treatments in the dental surgery and gloves re-used, provided they are undamaged. A series of experiments are described, which evaluate the effectiveness of four handwashing agents at removing defined bacterial inoculae from two types of latex rubber glove, a dedicated dental procedure glove (Regent Biogel D) which has a rough surface and a smooth-surfaced examination glove (Microtouch). The four agents tested were povidone iodine (Betadine), chlorhexidine (Hibiscrub), 60% iso-propyl alcohol, and a detergent triclosan preparation (Kleenex washcream). The Biogel D gloves required slightly shorter washing times to eradicate organisms than the Microtouch gloves. It was found that washing with water alone reduced the organisms on gloves by 300-1000-fold, but a minimum washing time of 20 seconds with povidone iodine or chlorhexidine was required to eradicate all the organisms inoculated, except bacterial spores, from both glove surfaces. Povidone-iodine and chlorhexidine were more effective washing agents than iso-propyl alcohol and triclosan soap.

1-Propanol↗
PubMed2003

Adverse reactions to protective gloves used in the dental profession: experience of the UK Adverse Reaction Reporting Project.

The Adverse Reaction Reporting Project (ARRP) was set up to measure the extent and severity of adverse reactions to dental materials in the UK. Further analysis into the use of protective gloves has been carried out to establish the degree to which gloves are having a deleterious effect on the dental profession. In addition the survey aimed to establish the techniques used to manage adverse reactions and their effectiveness. In a 23-month period, 369 reports were received concerning adverse reactions to protective gloves used in dental practices. Reporters were contacted for further information, and a 92% response rate was achieved. The 330 reports analysed showed dentists to be the largest group to report adverse reactions, whilst dental technicians reported the fewest. The referral rate for staff and patients was similar with a third of adverse reactions being referred (n=110) to a specialist for diagnosis. A confirmed diagnosis was received in 65% of referred cases (n=72), but the symptoms reported suggested a larger degree of Type I reactions occurring than diagnosed. The use of non-powdered gloves appeared to be favoured over powdered gloves in 42% of glove changes, and nitrile gloves were used as an alternative to latex in 39% of changes. In conclusion, the results from this survey showed that wearing gloves in dental practices in the UK caused a range of adverse reactions. In 79% (n=330) of cases reported and analysed, these reactions were readily resolved or improved by self-medication, prescribed medication and/or changing to a different type of protective glove.

Dental Staff↗
PubMed2003

Evaluation of aloe vera gel gloves in the treatment of dry skin associated with occupational exposure.

OBJECTIVE: An examination glove that delivers aloe vera (AV) gel to the gloved hand was studied in 30 adult females with bilateral occupational dry skin with or without irritant contact dermatitis (with or without erythema, fissures, and excoriations). METHODS: All participants were factory assembly-line workers with repeated superficial skin trauma who attributed their dry, irritated, emollient-dependent skin to a common cause (occupational exposure). Participants were sequentially enrolled (after written informed consent, n = 29 evaluable participants) into an open, contralateral comparison study to evaluate efficacy of AV glove use 8 h/day to one hand versus no use to the opposite hand for 30 days, followed by 30 days rest, followed by 10 days of repeated use. Participant's dorsal hands were documented by standardized photos at baseline, during, and at the end of study. RESULTS: Unblinded investigator baseline assessment rated dry skin as mild to moderate (n = 27), or moderate to severe (n = 2). Mean time to noticeable improvement for the AV glove hand was 3.5 days (range: 2-6 days) whereas marked improvement was 10.4 days (range: 7-17 days) for the AV glove hand. No improvement was detected for nonglove hands. Blinded photo assessment was rated independently by dermatology research staff. End-of-study mean global assessment of AV glove hands versus nonglove hands was 1.3 for AV glove hand (0 = no change, 1 = good [10%-89% global improvement], 2 = marked improvement [90%-100% global improvement]) versus 0 for nonglove hand (P <.0001). Mean global end-of-study assessments by the participants = 2.0 for AV glove hand versus 0 for nonglove hand. CONCLUSION: Dry-coated AV gloves that provide for gradual delivery of AV gel to skin produced a uniformly positive outcome of improved skin integrity, decreased appearance of fine wrinkling, and decreased erythema in the management of occupational dry skin and irritant contact dermatitis.

Adult↗
PubMed2003

Evaluation of the rate, location, and morphology of perforations in surgical gloves worn in urological operations.

Surgical perforation or intrinsic defects within the polymer membranes of surgical gloves are responsible for an increased exposure, and consequently infection risk, to HIV and HCV or other infectious diseases for the medical healthcare professional. A prospective field study was undertaken to evaluate the number and location of glove perforations, tested by the waterfill test. The morphology of these perforations was then inspected by stereo light and scanning electron microscopy. By comparing in-use defects to simulated defects created by medical instruments in unused gloves it was possible to categorize perforations caused by intrinsic defects or extrinsic mechanical stress. In six different types of surgical gloves collected from 720 urological operations the waterfill test revealed leakage rates of 6.6 percent to 12.3 percent. Further assessment of these gloves revealed intrinsic polymer material defect rates of 0.2 percent to 3.3 percent. The in-use acquired instrumental and mechanical perforation rate ranged from 4.6 percent to 12.15 percent. Perforations were mostly located at the index finger (left > right) or the thumbs. The morphology of the intrinsic defects was visualized as either incorporated membranous air bubbles or granular areas. The simulation of defects by surgical instruments in unused gloves resulted in the production of a catalog for comparison with defects seen in used gloves. This knowledge of the location and cause of these perforations highlights the need for a better avoidance strategy and/or establishment of a schedule for routine glove change by surgeons. In addition, the intrinsic polymer film quality of gloves can be improved by a lower incidence of air bubbles together with less granular sites.

Equipment Failure Analysis↗
PubMed2002

A method for reducing adaptor misalignment when testing gloves using ISO 10819.

OBJECTIVES: International standard ISO 10819 was established in order to quantify the vibration attenuation characteristics of anti-vibration gloves. One problem that exists with the standard is possible misalignment of the palm adaptor that is placed underneath the test glove. If the adaptor becomes misaligned, the measured glove transmissibility will be lower than the actual value. A tri-axial accelerometer was installed in the adaptor and was used as the basis for providing visual feedback of the adaptor alignment to the test subjects. The objective of this study was to test the hypothesis that adaptor misalignment could be reduced by providing feedback to the test subjects. METHODS: Eight male volunteers (mean age 24.8 yr) were used in the study. Each subject performed two sets of tests: the standard ISO 10819 glove test and the modified version. Three different anti-vibration gloves were tested. Glove transmissibility and adaptor misalignment were calculated for each glove. A three-way analysis of variance was used to analyze the results. RESULTS: A comparison of the two testing methods showed that the modified glove testing method did reduce misalignment significantly, which, in turn, resulted in an increase in the measured glove transmissibility. CONCLUSIONS: The proposed method greatly improved the standard deviation of transmissibility and made the test results more consistent.

Adult↗