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PubMed1992

The incidence of surgical glove perforation during obstetric and gynaecological surgical procedures.

The increasing prevalence of diseases such as AIDS and hepatitis B makes safe surgical techniques more important than ever before. Intact surgical gloves act as a barrier against these infections and a study was therefore done to determine the incidence of surgical glove perforation during obstetric and gynaecological surgical procedures. Surgical gloves were collected and tested for perforations following 353 consecutive obstetric and gynaecological operations. Forty pairs of new unused surgical gloves were tested for perforations in the same way. Whereas none of the 40 control pairs of gloves was found to be perforated, 22%-24% of used gloves were perforated. The experience of the surgeon had no influence on the incidence of glove perforation (P = 0.997; chi 2-test). Left-hand gloves were more frequently perforated than right-hand gloves, but this difference was not statistically significant (P = 0.075: chi 2-test). These findings must be a source of concern to all those practising obstetrics and gynaecology and measures are therefore suggested to decrease the risk of HIV or hepatitis B transmission during operations.

Equipment Failure↗
PubMed2005

A study on powdering of reusable surgical gloves.

OBJECTIVES: To study the need of powdering surgical gloves and to produce a powdering machine. MATERIAL AND METHOD: The need of powdering surgical gloves was done by questionnaires to directors or chiefs of purchase departments in 29 hospitals across the country. The practice in powdering surgical gloves was given by chiefs of the central sterile supply department (CSSD). A powdering machine was produced by the researchers in consultation with CSSD personnel in a hospital. The quality of powdering surgical gloves was evaluated by infection control nurses in the hospital. Cost comparison was done by a health economist. RESULTS: The study in 2002 revealed that all of the 29 hospitals used recycled surgical gloves. Powdering of surgical gloves was done by hand in 27.6% and by powdering machine in 62.10%. Corn powder was used in 55.2% and talc in 41.4%.Defects in powdering ranged from 1.1% to 51.7%. No defects was found in surgical gloves powdered by the machine produced by the researchers. The costs for powdering and one pair of reused surgical gloves were 0.10 and 5.59 baht respectively. CONCLUSION: Surgical gloves were reused in all hospitals in Thailand The powdering machine was effective and was not difficult to make.

Central Supply, Hospital↗
PubMed1989

Results of microbiological investigations on the permeability of procedure and surgical gloves.

Procedure gloves are considered to be important to prevent infections when handling potentially contaminated items. We tested two sorts of vinyl- and 4 sorts of polyethylene-copolymer-gloves, 20 gloves of each, towards the ability of Proteus mirabilis ATCC 15143 to penetrate the glove material. The gloves were fastened in bottles containing 700 ml sterile nutrient broth and then filled with 300 ml of a bacteria suspension having a density of 10(8) cfu/ml. The samples were taken directly and 0.5, 1, 2, 3, 4, 6 and 24 h after starting the test. Immediately after the inoculation in 10 to 85% of the gloves a migration of Proteus mirabilis could be detected. After 24 h the rate was 25 to 90%! The penetration of Escherichia coli-lambda-phages (10(6) pfu/ml) was investigated in a similar arrangement. Here 20 to 90% of the gloves were previous in the first 5 to 10 min. Additionally tested latex gloves were impermeable up to 4 h after inoculation. The results of this study lead to the conclusion that it is necessary to improve glove materials. To examine the impermeability for microorganisms the methods used in this investigation are recommended as quality control procedures.

Bacteriophage lambda↗
PubMed1996

Use of a semipermeable glove during treatment of hand dermatitis.

Forty-six subjects with hand dermatitis participated in a pilot study comparing a new semipermeable glove to a standard cotton glove. A variety of diagnoses were represented. Each subject received treatment with topical steroids and/or moisturizers and used one each of the experimental and cotton gloves for approximately one month. Physicians scored skin condition before and after treatment. Subjects evaluated skin comfort and practical aspects of using each type of glove. Thirty subjects completed the study protocol. The type of glove used had no impact on skin condition at follow up, with both groups of hands improving. Patients expressed a preference for the experimental gloves, noting improvements in skin and hand comfort, dexterity, cleanliness, and ease of use. Feedback suggested that the gloves will be well tolerated and patient compliance in using the gloves will be high. Evaluation of the gloves' value for prevention and chronic management of hand dermatitis is warranted.

Administration, Topical↗
PubMed1998

Laboratory simulation of splashes and spills of organophosphate insecticides on chemically protective gloves used in agriculture.

Agricultural workers rely on chemically protective gloves for protection from dermal exposure to insecticides. In Australia the most widely used gloves are manufactured from polyvinyl chloride or nitrile butadiene rubber. During insecticide application splashes and spills frequently occur on the external surfaces of gloves which may compromise the integrity of the membrane. Interaction of two organophosphate insecticides, chlorpyrifos (Lorsban 500 EC(R)) and diazinon (Jetdip(R)), with glove surfaces was investigated in laboratory conditions. The external surface of gloves was treated with concentrated insecticides for one minute and diluted and concentrated insecticides for 24, 36 and 48 hours and later examined by environmental scanning electron microscopy. Two classes of defects, cavities and convexities, were evident in the polyvinyl chloride gloves following all treatments, whereas cracking was significant in the nitrile butadiene rubber gloves after 24 hours. In addition, X-ray energy-dispersive microanalysis was used to evaluate chemical changes on the glove surfaces. Phosphorus and sulfur were useful indicators for organophosphate retention over specific time frames. Results corroborated the need for more robust chemically protective gloves to be developed for routine agricultural use.

Agricultural Workers' Diseases↗
PubMed1984

Permeation through five commercially available glove materials by two pentachlorophenol formulations.

Five glove materials were tested for permeation by two commonly used formulations of pentachlorophenol (PCP). Permeation was conducted using the method used in two prior studies by NIOSH. The lower limit of PCP quantitation in the receiving side of the permeation cell was 70 parts per billion (ppb). When challenged with a 4.3% PCP in diesel oil solution, both the Dayton Flexible Products Triflex (PVC) and the Best 64 NFW (natural rubber) gloves exhibited breakthrough times thirty seconds after exposure. The Playtex #835 (latex/neoprene) glove exhibited breakthrough after sixty minutes, but showed a five fold greater rate of permeation than the Dayton and the Best glove. Neither the Edmont Sol-Vex (nitrile rubber) nor the Granet Glo-Gluv (PVC) gloves had been permeated after testing for 8 and 16 hours respectively. Following challenge with a 4.2% sodium pentachlorophenate solution, only the Best (natural rubber) glove allowed breakthrough; this only thirty seconds after exposure. Neither the Dayton (5 hours), Playtex (7.5 hours), Edmont (15.5 hours), nor Granet (15.5 hours) gloves had been permeated following completion of testing after the listed duration. This study has shown that different gloves offer differing resistance to permeation by PCP based upon the composition of the glove and the PCP formulation tested.

Chlorophenols↗
PubMed1984

Permeability of latex and polyvinyl chloride gloves to carmustine.

Permeability of latex and polyvinyl chloride gloves to the antineoplastic agent carmustine was studied. The latex gloves were of two types: sterile surgical gloves and disposable utility gloves. Polyvinyl chloride gloves of two thicknesses (0.20 mm and 0.35 mm) were tested. Both single and double thicknesses of each material were exposed to carmustine 3.33 mg/ml in a 10% aqueous solution of ethanol, and to the solvent alone, for 5-90 minutes. Permeation of carmustine was tested using a mutagenicity assay and a chemical assay. A time-dependent increase in carmustine permeation was observed for all types of materials (both double and single thicknesses). Mean amounts of carmustine permeating single gloves at 90 minutes ranged from 53 to 86 micrograms for the mutagenicity assay and 49 to 78 micrograms for the chemical assay. Double thicknesses of glove material (especially of the thicker polyvinyl chloride) reduced the amount of drug permeation. These latex and polyvinyl chloride glove materials offer only limited protection against contact exposure to carmustine. Latex surgical gloves may be slightly less permeable than the other types tested.

Carmustine↗
PubMed1995

Glove-induced dermal and respiratory symptoms among health care workers in one Finnish hospital.

To evaluate the prevalence of skin and respiratory symptoms associated with the use of protective gloves in health care workers, an inquiry study was carried out on 534 hospital employees who used protective latex or vinyl gloves on a daily basis at work. The prevalence of skin disorders related to the usage of gloves was 56%. Rhinorrhea or nasal congestion was present in 13% of the workers who used powdered disposable gloves. The prevalence of both skin and respiratory symptoms was significantly higher among the workers who used gloves > 2 hours a day (p < 0.001). The skin disorders were more common in young employees. The findings indicate that most of the symptoms were caused by irritation or an immediate, IgE-mediated allergy. We conclude that there is a positive correlation between the duration of daily glove usage at work and the skin and respiratory symptoms. In order to reduce skin disorders associated with the daily use of gloves, it is necessary to develop safer materials in the glove manufacturing process.

Adult↗
PubMed2001

Natural rubber latex-related occupational asthma: association with interventions and glove changes over time.

BACKGROUND: Exposure to natural rubber latex (NRL) has been recognized as a cause of occupational asthma (OA), especially among health care workers (HCWs) associated with use of gloves. Little or no population-based data are available which chart the changes over time in the number of cases of OA as this problem was increasingly recognized and then interventions instituted. METHODS: We obtained the numbers of allowed asthma claims with exposure to latex by year in the province of Ontario, Canada from the Ontario Workplace Safety and Insurance Board; details of the cases from the largest teaching hospital were reviewed. Interventions included: (1) in 1996, the Board recommended in its focus for accommodation of sensitized workers, the reduction of aerosols of latex proteins and that hospital facilities use powder-free, low-protein or nonlatex gloves; and (2) hospitals instituted latex policies and glove changes at various dates. For example, at the largest teaching hospital, interventions included education and voluntary medical surveillance in 1994; substitution of low protein, "powder-free" NRL gloves for non-sterile powdered gloves in 1995; and replacement of powdered sterile NRL gloves by lower protein, "powder-free" NRL gloves in 1997. RESULTS: Through 1999, there were 60 allowed claims for asthma in Ontario with exposure to latex; of these 49 (82%) were among HCWs. The number of claims among HCWs changed from 0 to 2 per year up to 1990; increased to 7 to 11 per year between 1991-1994; and declined to 3 per year in 1995-1996 and 1 to 2 per year in 1997-1999. Of the ten institutions having two or more OA latex claims, all claims occurred in 1996 or earlier at 8 (80%). At the largest hospital, there were five accepted claims with year of diagnosis in 1993 (1 case), 1994 (3 cases), and 1995 (1 case). CONCLUSIONS: These findings suggest that, despite the effect of increasing recognition, the introduction of gloves with reduced powder and/or protein, as well as other interventions have been associated temporally with declines in the number of cases of latex OA.

Adult↗
PubMed1988

Surgical glove perforation.

In a study to investigate the incidence and significance of surgical glove perforation, bacterial contamination of surgeons' hands and gloves before and after operation was measured and the gloves tested for damage. Perforations were found in 74 of 582 gloves (12.7 per cent) and occurred in 34.5 per cent of operations. Glove perforation did not influence bacterial counts on the surgeons' hands or on the outside of their gloves. A separate clinical study of 100 adult hernia repairs gave no evidence that perforation increased wound sepsis. After standard pre-operative hand preparation, glove perforations are of no clinical significance to the patient, but their high incidence should alert surgeons to the need for protection against pathogens transmissible during surgery, such as hepatitis B and the human immunodeficiency virus. Protection of the surgeon is the main indication for preoperative change of damaged gloves.

Equipment Contamination↗
PubMed2004

Abrasion resistance of medical glove materials.

Due to the increasing demand for nonlatex medical gloves in the health-care community, there is a need to assess the durability of alternative glove materials. This study examines durability characteristics of various glove materials by abrasion resistance testing. Natural rubber latex (latex), polyvinyl chloride (vinyl), acrylonitrile butadiene (nitrile), polychloroprene (neoprene), and a styrene-ethylene/butylene-styrene block copolymer (SEBS) were tested. All test specimens, with the exception of the vinyl, were obtained from surgical gloves. Unaged out-of-the-box specimens as well as those subjected to various degrees of artificial aging were included in the study. After the abrasion sequence, the barrier integrity of the material was assessed through the use of a static leak test. Other traditional tests performed on these materials were viral penetration to validate the abrasion data and tear testing for comparative purposes. The results indicate that specific glove-material performance is dependent upon the particular test under consideration. Most notably, abrasion, even in controlled nonsevere conditions, may compromise to varying degrees the barrier integrity of latex, vinyl, SEBS, nitrile, and neoprene glove materials. However, as evidenced by the results of testing three brands of neoprene gloves, the abrasion resistance of any one glove material may be significantly affected by variations in production processes.

Gloves, Protective↗
PubMed1999

Surgical gloves: current problems.

One century ago surgical gloves were introduced to practice as part of the new antiseptic technique and originally to protect the hands of the surgeon and his assistants from the harmful dermatologic effects of powerful antiseptics (e.g., carbolic acid) in use at that time. Since then, the wearing of gloves during surgery has been standard practice. Furthermore, the protection value of surgical gloves in preventing cross-infection has stood the test of time. Nevertheless, materials used in glove manufacturing have caused a succession of iatrogenic problems in surgical patients over the years. More recently, emergence of transmissible viruses, such as hepatitis B and C and human immunodeficiency virus, has led surgeons to consider their own safety with the frequent possibility of perforation of surgical gloves by sharp instruments. In this review we discuss the problems associated with surgical glove practice: glove powder-induced peritonitis and adhesions, latex rubber-associated hypersensitivity, and glove perforation.

Anti-Infective Agents, Local↗
PubMed1989

Effects of dental medicaments on examination glove permeability.

Dental care providers wear gloves for all clinical procedures. This study was designed to assess the intactness of examination gloves after exposure to commonly used agents. Finger portions from latex and vinyl examination gloves were sealed to syringe barrels and exposed to alcohol, eugenol, a surface disinfectant, cavity varnish, or commercial mouth wash. Tritiated water was introduced into the finger-tip portion, which was suspended in a vacuum flask containing distilled water. Aliquots of water were withdrawn from the flask at intervals of 5 minutes to 8 hours and analyzed for transfer of radioactivity through the glove tip. Treatment with agents such as eugenol and cavity varnish resulted in significant leakage after 5 to 15 minutes. Although some agents apparently quickly damaged the gloves, leaks developed in untreated gloves with time. Results suggest that visibly intact gloves may have developed microleaks and that changing gloves during long clinical procedures may be indicated.

Dental Cavity Lining↗
PubMed1993

Use of gloves and handwashing behaviour among health care workers in intensive care units. A multicentre investigation in four hospitals in Denmark and Norway.

Glove use and handwashing frequencies (HW) were observed in intensive care units (ICU) in two university hospitals in Denmark and two in Norway. The study included a total of 1632 patient procedures performed by 325 persons. Handwashing (HW) has become an important part of general barrier precautions. Earlier studies have shown that health care workers (HCW) far too often neglect to wash their hands after patient procedures when handwashing is strongly recommended. Despite earlier claims that increased glove use in hospitals would discourage handwashing, our results showed that HCW washed their hands more often after glove use (57%) than when gloves had not been used (40%). This significant difference in HW frequency was also noted when similar procedures were carried out by HCW with or without gloves. This might be a matter of personal discomfort after wearing gloves, but could also be due to differences in awareness of hygienic aspects of patient care. In the two countries gloves were used on average at 17% of the procedures, but were not used appropriately for dirty procedures. The results of this study indicate that more effective methods for the implementation of appropriate glove use and HW should be emphasized.

Denmark↗
PubMed2006

Role of protective gloves in the causation and treatment of occupational irritant contact dermatitis.

Irritant contact dermatitis of the hands is a significant occupational problem. Management primarily involves cessation of exposure to hazardous substances. Protective gloves can reduce or eliminate exposure of the hands to hazardous substances if used correctly, but if not selected and used correctly, protective gloves can actually cause or worsen irritant contact dermatitis of the hands by increasing exposure of the hands to hazardous chemicals. We present two cases of occupational irritant contact dermatitis of the hands caused by incorrect use of protective gloves. Glove failure can occur by penetration, permeation, or contamination, and all 3 mechanisms were operative in these cases. These cases demonstrate that correct use of gloves is at least as important as selection of gloves made of the appropriate material. By understanding mechanisms of glove failure, clinicians can make more appropriate recommendations for the selection and use of protective gloves in the workplace.

Adult↗
PubMed2005

Are sterile gloves necessary in nonsurgical dental extractions?

PURPOSE: The aim of the study was to compare the incidence of healing complications of extraction socket with the use of sterile or clean nonsterile gloves during nonsurgical dental extractions. MATERIAL AND METHODS: This was a randomized prospective study conducted at the exodontia clinic of the Department of Oral and Maxillofacial Surgery of the Lagos University Teaching Hospital (Nigeria), between October 2002 and January 2003. Patients who were referred for nonsurgical extractions of permanent teeth and who satisfied the inclusion criteria into the study were randomly allocated into 2 groups. One group had their extractions performed with the surgeon wearing a pair of sterile gloves and the second group had their extractions performed with the surgeon wearing a pair of clean nonsterile gloves. Two hundred sixty-nine patients who had 301 teeth extracted and satisfied the inclusion criteria for socket healing assessment were assessed for postoperative socket healing. RESULTS: Three different types of socket healing complications were identified (dry socket, acutely inflamed socket, and acutely infected socket). A total of 32 patients (11.9%) developed socket healing complications. Nineteen of 122 patients in the sterile glove group and 13 of 147 patients in the clean nonsterile glove group developed socket healing complications (P = .09). CONCLUSION: The study confirmed that the use of sterile surgical gloves offers no advantage over clean nonsterile gloves in minimizing extraction socket healing complications following dental extraction. Therefore, nonsurgical dental extraction can be safely performed with the surgeon wearing clean nonsterile gloves.

Adolescent↗
PubMed1992

Glove perforations in ophthalmic surgery.

To determine the potential rate of intraoperative parenteral exposure of physicians and patients caused by glove perforation during ophthalmic surgery, gloves were analyzed after 125 procedures. Gloves were collected from all surgical team members (surgeon, assistants, scrub nurse, and circulating nurse). The rate of glove perforation was significantly lower for the surgeon, 0.3% (one of 303 gloves) than for the assistants, 5% (ten of 202 gloves [P = .001]), scrub nurses, 16% (52 of 326 gloves [P = .0001]), and circulating nurses, 15% (43 of 293 gloves [P = .0001]); similarly, assistants had a significantly lower rate than did scrub nurses (P = .0001) and circulating nurses (P = .001). There was no statistically significant difference in number of perforations on the basis of surgery duration or type of ophthalmic procedure. These findings suggest that the risk of parenteral exposure during ophthalmic surgery is low for the surgeon, and higher for other surgical personnel. We also analyzed additional safety precautions. Further study is warranted to determine the effectiveness of precautions and to guide policy formulation.

Equipment Failure↗
PubMed2002

Glove punctures and postoperative skin flora of hands in cardiac surgery.

BACKGROUND: Surgical gloves are frequently perforated during operations, including heart operations. This infection risk factor is inadequately studied. METHODS: After preoperative hand disinfection and at the end of 116 heart operations, bacterial samples from hands of surgeons, altogether 800 samples, were taken. Glove punctures were examined with water test. RESULTS: Surgeons changed 70 gloves because of breakage during operations. Additionally, 154 of 400 (39%) gloves had holes in postoperative testing. The breakage rate of gloves increased from 30% in operations shorter than 3 hours to 65% when operations were longer than 5 hours. High bacterial counts of the hands were also more common after prolonged operations. CONCLUSIONS: Glove puncture rates and bacterial counts of hands increase with increasing operation time. We recommend changing of both gloves when a puncture is detected. Before donning new gloves, hands should be disinfected.

Aortic Valve↗