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At least 37 records · Page 2Linked to original sources
PubMed2002

Randomised controlled trial of glove perforation in single and double-gloving methods in gynaecologic surgery.

OBJECTIVE: To assess the value of double-gloving in gynaecological surgery. DESIGN: A prospective randomised controlled trial of glove perforation in single- and double-gloving methods. SETTING: Rajavithi Hospital between 1 September 1999 to 31 August 2000. SAMPLE: Eighty-eight (88) and 82 primary surgeons were selected at random to make up single- and double-gloving groups, respectively, while performing total abdominal hysterectomy (TAH) with or without bilateral salpingo-oophorectomy (BSO). METHODS: The gloves were tested by immersion in water. RESULTS: The glove perforation rate was 6.09% and 22.73% in double-inner and single gloves, respectively, with this difference being statistically different (p < 0.05). There was no significant difference between the glove perforation rates in single gloves (22.73%) and in double-outer gloves (19.51%). There was matched perforation of the same finger of both outer and inner gloves in 1.22% of total double-inner gloves. CONCLUSIONS: The double-gloving methods significantly reduced the risk of surgeons' hands contacting blood, when compared with the single-gloving method, in TAH with/or without BSO.

Equipment Failure↗
PubMed2003

Incidence of glove failure during orthopedic operations and the protective effect of double gloves.

OBJECTIVE: To determine the usefulness of double gloves in protecting against the exposure of surgical team members' hands to blood. METHODOLOGY: Five-hundred-ninety-six gloves were studied during 71 orthopedic operations using the water-loading test (filling a glove with water and occluding its cuff tightly to identify leaking points). RESULTS: In all, 73 glove perforations occurred, but only nine resulted in exposure to blood (blood touching the skin). The incidence of glove perforation was 12% (73/596), and overall exposure (blood touching the skin) per operation was 13% (9/71). The latter would have been 87% (62/71) but for the use of double gloves. Sixteen percent of the perforations in double gloves were in the inner gloves, while 84% were in the outer gloves. Exposure of surgeons was reduced from 54% to 10%, first assistants from 27% to 3%, and second assistants from 7% to 0 (p < 0.02, df = 2) by double-gloving. Significantly more perforations occurred during operations on bone, compared with soft tissue operations, p < 0.0001, RR = 4 (95% CL 1.87-8.55). The most common sites of glove perforation were the index finger (47%), thumb, and the palm region: 14% each. More glove perforations occurred in nondominant hands. CONCLUSION: Double-gloving offers additional protection to surgeons and assistants by preventing hand exposure to blood intraoperatively.

Equipment Failure↗
PubMed1996

Efficacy of double gloving with a coloured inner pair for immediate detection of operative glove perforations.

OBJECTIVE: To compare the efficacy of double gloving with an inner coloured pair of gloves and double gloving with classic gloves, for prompt detection of perforation during a single standard operation. DESIGN: Prospective, randomised study. SETTING: Teaching hospital, France. SUBJECTS: 100 Consecutive patients with haematological malignancy or AIDS, who were referred for implantation of a vascular access port. INTERVENTIONS: Insertion of a central line with an implantable chamber under local anaesthesia. The use of double gloving with an inner coloured pair or with classic gloves was decided preoperatively by random allocation. MAIN OUTCOME MEASURES: Visual detection of one or more perforations on one or more gloves during operation, localisation of the perforation(s), and post-operative evaluation of the water tightness of the gloves. RESULTS: There were a total of 14 perforations of the outer gloves, 9 were detected during operation in the coloured inner pair group compared with none in the standard gloves group. Postoperative testing showed that there were no undetected perforations in the coloured inner pair group compared with 5 in the standard gloves group. CONCLUSIONS: Double gloving with a coloured inner pair is effective in the peroperative detection of accidental perforations in surgical gloves.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Latex gloves use and symptoms in health care workers 1 year after implementation of a policy restricting the use of powdered gloves.

BACKGROUND: Latex sensitization related to glove use is a complex problem, and glove use policies that restrict exposure to powdered latex gloves alone may not provide adequate safety. This study explored health care workers' (HCWs') latex glove use and reports of related health symptoms 1 year after implementation of the latex glove replacement policy. METHODS: Two cross-sectional surveys. One was a population-based survey of HCWs at the institution (National Surveillance System for Hospital Health Care Workers); the second, a detailed survey of HCWs stratified by exposure to latex gloves (Latex Symptom Survey). RESULTS: The prevalence of symptoms of dermatitis reported by latex glove users was 40.3% (National Surveillance System for Hospital Health Care Workers) and 50.0% (Latex Symptom Survey). Symptom reports increased as exposure to latex gloves increased (pairs used per day, occupations with more glove use, working in higher exposure areas, more tenure, and more hours of use per day). Aerosol symptoms and urticaria related to latex glove use were reported much less frequently than were rash, chapping, itching, or redness. HCWs, even those with skin symptoms, continued to choose latex gloves in more than 80% of the cases. CONCLUSIONS: Stepwise preplacement evaluation at employee health clinics is recommended to identify and protect employees sensitized to latex. The medical community needs more understanding and education about latex gloves, latex sensitization, and available alternatives.

Academic Medical Centers↗
PubMed2004

Glove perforations in open and laparoscopic abdominal surgery: the feasibility of double gloving.

BACKGROUND AND AIMS: According to the traditional view, the glove protects the patient from the bacterial growth of the surgeons' hands and doing so prevents infections. Today, with growing incidences of HIV and Hepatitis B and C, surgical gloves are also important as protection for the surgeon. We compared the safety of double indicator gloves to standard single surgical gloves by investigating how often surgical gloves are punctured in laparoscopic and open gastrointestinal surgery. STUDY: As study material we gathered all gloves that had been used in gastrointestinal surgery in Satakunta Central Hospital during two months. 814 gloves from 274 operations were tested by using standardized water filling test method. RESULTS: In open surgery 67 gloves out of 694 had been punctured (9.6 percent). Puncture occurred in 22.5 percent of operations (53 out of 236). During open surgery 24 holes out of 35 were undetected with single gloves (69 percent). With double indicator gloves, only 3 out of 31 holes were unnoticed (10 percent). Long duration of operation increased the risk of puncture. In laparoscopic operations 4 gloves out of 120 had been perforated (3.3 percent). CONCLUSION: Double surgical gloves give markedly better protection in surgery. This is important especially in high risk operations.

Chi-Square Distribution↗
PubMed1996

Surgeon protection: early recognition of glove perforation using a green under glove.

This paper reports the use of a double gloving system, which consists of a standard latex over glove and a green latex under glove, and aids recognition of intra-operative glove perforation during trauma surgery. Recognition of perforation is possible due to the colour of the under glove becoming more visable following ingress of fluid between the glove layers. The gloves were used in 40 consecutive operative procedures for lower limb fracture fixation. Glove perforations occurred in 48% of operations. The outer glove was perforated on 26 occasions and the under glove on two. There were no false positive colour changes but on one occasion no indication of perforation was visible. The rapidity and accuracy of colour change allowed identification of the cause of glove damage intra-operatively. This was most often due to powered instrumentation (58%).

Accidents, Occupational↗
PubMed2000

Incidence of glove perforations in gastrointestinal surgery and the protective effect of double gloves: a prospective, randomised controlled study.

OBJECTIVE: To investigate the incidence of glove perforations during various types of gastrointestinal surgery, to record the incidence of blood contamination of the hands, and to evaluate the protective effect of double gloving. DESIGN: Randomised prospective trial. SETTING: University hospital, Denmark. MATERIAL: 566 pairs of gloves tested on surgeons, assistants, and scrub nurses. INTERVENTIONS: The participants were allocated to wear either single gloves or Indicator double gloves. MAIN OUTCOME MEASURES: The number of glove perforations and the incidence of blood contamination of the hands. RESULTS: The perforation rate in single gloves was 53/306 (17%), and that of both outer and inner Indicator gloves at corresponding sites was 6/260 (2%) (p < 0.0001). Double gloving reduced the rate of blood contamination of the hands among surgeons from 15/115 (13%) to 2/98 (2%) (p < 0.005). CONCLUSION: The use of Indicator double gloves is recommended in gastrointestinal surgery because of the appreciable protection against blood contamination that they offer.

Digestive System Surgical Procedures↗
PubMed2003

[Defects in the surgical glove barrier. Single or double gloves].

The purpose of wearing surgical gloves is to provide an antimicrobial barrier between the hands of the surgical staff and the tissues of the patient. Glove perforations are common, depending on the function of the staff member and the duration and nature of the surgery. In addition, gloves can hydrate, which is also a potential route of infection. The use of two pairs of gloves (double gloves) efficiently reduces both the perforation rate and the hydration of the glove barrier. Decreased dexterity and tactile sensitivity, however, are common objections, which keep many surgeons from wearing double gloves. Moreover, they seem to have little practical importance. Neither single nor double gloves have proved their effectiveness in terms of actual infections, but it seems rational to maintain a surgical glove barrier. Double gloves can be recommended as a simple means of improving the integrity of this barrier.

Blood-Borne Pathogens↗
PubMed1999

Double gloving and a system for identifying glove perforations in maxillofacial trauma surgery.

The treatment of some maxillofacial fractures has an incidence of glove perforation as high as 50%, with over 80% going unnoticed at the time of operation. We investigated double gloving and a glove perforation indication system to ascertain whether the latter offered any additional protection. 1061 gloves used for 113 patients were examined. The outer glove perforation rate was significantly higher than the inner glove (0.48 compared with 0.10, P < 0.0001). There were fewer unnoticed perforations in the glove perforation indication group than the standard surgical glove group (19% compared with 79%, P < 0.0001). The indication system was most effective in wet operating fields. The perforation rate varied with the type of fracture and treatment. Mandibular fractures that were 'hand-held', while bone-plated had a lower mean number of outer glove perforations/operation than fractures treated with temporary intermaxillary fixation (0.43 compared with 4.62, P < 0.0001).

Chi-Square Distribution↗
PubMed1999

Failure of glove hole detection device for synthetic gloves.

Holes in latex gloves can be reliably detected by commercially available electronic devices. The purpose of this study was to compare the performance of an electronic glove hole detection device using latex gloves to that of neoprene, vinyl, and nitrile latex-free gloves. The electronic hole detection device accurately detected holes in the latex gloves during the 2-h study. In contrast, the latex-free gloves were immediately conductive of electricity in the absence of holes. Consequently, electronic glove hole detection devices cannot be reliably used with latex-free gloves.

Electronics↗
PubMed2006

Bacterial count comparisons on examination gloves from freshly opened boxes versus nearly empty boxes and from examination gloves before treatment versus after dental dam isolation.

Use of gloves in dentistry is primarily for protection of the healthcare worker, yet little information is available regarding potential patient issues such as microbial contamination of gloves before and during use. The purposes of this study were to compare gloves from newly opened boxes with those from boxes that had been in dental operatories until they were nearly empty and to determine if gloves are contaminated though diagnostic procedures and rubber dam placement. Eight endodontic residents provided samples by streaking gloved fingers on nutrient agar plates. Results showed no statistically significant difference between counts from new boxes versus nearly empty boxes (n = 32, p < 0.6216). Gloves after rubber dam placement yielded a mean colony count of 158 versus a 1.5 mean of fresh gloves (n = 64, p < 0.0001). These results suggest that the use of new gloves before opening a tooth for endodontic therapy may be warranted.

Dental Offices↗
PubMed1998

Risky business: pre-powdered gloves or powder-free gloves in the operating suite?

Two of the emerging issues for the health-care sector in the 1990s are occupational health and safety, and iatrogenic issues. Both of these issues are implicated in the use of pre-powdered latex gloves. Hospital health-care workers are exposed to latex in many ways: gloves, intravenous sets, ventilator circuits, dental products, resuscitation equipment, anaesthetic equipment. Post-operative complications, delayed wound healing, scar formation, and the potential for misdiagnosis, in the presence of starch powder, have been well documented in the literature with the need for through glove rinsing prior to surgery. Another route for glove powder to enter wounds is through a barrier breach. For an institution to ensure it provides the most durable and effective barrier for healthcare worker protection and patient safety, knowledge is needed regarding the various factors which lead to glove barrier failure. The primary aim of the study was to evaluate the in-use durability of the surgical gloves in current use against powder-free gloves. Descriptive statistics were used to analyse the data, in addition a cost analysis was calculated. The results of this study demonstrated clinically important differences between existing glove products in terms of barrier quality.

Australia↗
PubMed2005

Allergen profiles of natural rubber latex (NRL) proteins on gloves and glove powders.

The contributing role of glove powder in sensitization to natural rubber latex (NRL) proteins has been well documented in laboratory studies and through clinical evaluations. However, the quantitative relationship of the respiratory and topical exposures in the sensitization process remains unknown because the relative levels of protein on the glove powders in relation to the total levels of protein on NRL gloves have not been determined. In NRL allergens--Hev b 1, Hev b 3, Hev b 5, and Hev b 6.02--on randomly selected surgical and examination NRL gloves. We also examined the binding pattern of the four allergens to several glove powders that showed a different affinity to NRL proteins. The level of powder-bound protein was determined by the ELISA Inhibition Assay (ASTM D6499 standard method). Two cross-linked corn starch powders, one sample of cooking corn starch and one oat starch sample, were exposed to ammoniated (AL) or nonammoniated (NAL) raw NRL protein extracts. The levels of individual allergens were determined using the NRL allergen kit. In the NRL glove extracts we observed a wide range in the total allergen levels and a great diversity in the proportion of the four allergens. On the other hand, the evaluated starches had similar ratios of four individual allergens, regardless of the differences in their total allergen levels. The exposure of starches to NRL proteins with different allergen profiles did not affect the allergen ratio. All samples demonstrated a selective affinity for binding Hev b 1 and Hev b 5 allergens and a lesser affinity for the Hev b 6.02 allergen. Allergen Hev b 6.02 made up about 60% of the total allergen in the NAL extract, but only 12-30% of Hev b 6.02 was bound to starches. In contrast, there was only 3-7% of Hev b 1 allergen in the NAL extract, but powders had 35-45% of Hev b 1. These findings indicate that allergenic properties of NRL gloves and respective glove powders may be different.

Allergens↗
PubMed1988

Removal of nosocomial pathogens from the contaminated glove. Implications for glove reuse and handwashing.

STUDY OBJECTIVE: To evaluate the effectiveness of three different types of handcleansing agents in decontaminating gloved hands that were inoculated with a series of four nosocomial pathogens. DESIGN: A controlled, experimental trial. SETTING: Tertiary care referral center. PATIENTS OR OTHER PARTICIPANTS: Five healthy volunteers participated in all portions of the study. INTERVENTIONS: A standard concentration of one of four representative nosocomial pathogens was placed on the gloved hand, spread, and allowed to dry. One of three different handcleansing agents--a nonmedicated soap, a 60% isopropyl alcohol preparation, or 4% chlorhexidine gluconate--was used to cleanse the gloves, which were cultured using a broth-bag technique. The gloves were then removed and the hands were cultured in a similar manner. MEASUREMENTS AND MAIN RESULTS: The handwashing agents reduced the median log10 counts of organisms to 2.1 to 3.9 after an inoculation of 10(7) colony forming units. The proportion of positive glove cultures for Staphylococcus aureus, 8% to 100%; Serratia marcescens, 16% to 100%; and Candida albicans, 4% to 60% varied greatly after use of the different handcleansers (P less than 0.001), and varied considerably for Pseudomonas aeruginosa, 20% to 48% (P = 0.085). After the gloves were removed, the differences among the observed proportions of hands contaminated with the test organisms varied from 5% to 50%, depending on the handcleansing agent used (P less than 0.001). CONCLUSIONS: In the era of universal precautions these data suggest that it may not be prudent to wash and reuse gloves between patients. Further, handwashing is strongly encouraged after removal of gloves.

1-Propanol↗
PubMed1991

Allergic contact dermatitis to two antioxidants in latex gloves: 4,4'-thiobis(6-tert-butyl-meta-cresol) (Lowinox 44S36) and butylhydroxyanisole. Allergen alternatives for glove-allergic patients.

Allergic contact dermatitis developed on the hands and/or face of two patients after exposure to latex examination gloves. Both patients were patch test negative to the usual rubber allergens, but both had a positive patch test reaction to 4,4'-thiobis(6-tert-butyl-m-cresol) (Lowinox 44S36). Patient 2 was also patch test positive to butylhydroxyanisole. The patients were tested with other gloves, to find gloves that they could safely use. Glove manufacturers were queried to ascertain the occurrence of Lowinox 44S36 and butylhydroxyanisole in different brands of latex and vinyl examination gloves. A list of gloves and their associated allergens was generated and is provided to assist dermatologists in helping patients choose gloves free of specific allergens.

Allergens↗
PubMed1999

A whole-glove method for the evaluation of surgical gloves as barriers to viruses.

BACKGROUND: Today, because of the wide variety of infectious agents encountered in the health care environment, clinicians must be particularly concerned about the potential for small-sized virus penetration through glove defects. OBJECTIVE: To describe a method for testing gloves that evaluates the entire glove and allows for detection of low levels of virus penetration. Ten sets of 10 different gloves from 4 manufacturers were evaluated using this method. METHODS: Barrier properties were evaluated using the bacteriophage, phiX174. Gloves were filled with surfactant solution placed in flasks containing 10(6) viruses per mL. Flasks were agitated at 37 degrees C +/- 2 degrees C and assayed for 180 minutes. RESULTS: Virus penetration was detected in 8% of the 100 gloves tested using the quantitative assay. The qualitative assay determined that 14% of the gloves tested allowed penetration.

Evaluation Studies as Topic↗
PubMed2006

Touch sensitivity with sterile standard surgical gloves and single-use protective gloves.

The purpose of this study was to evaluate touch sensitivity and static two-point discrimination of the dominant index and middle finger in 20 anaesthetists wearing no gloves, single-use protective gloves or sterile standard surgical gloves. Semmes-Weinstein filaments were used to measure cutaneous pressure thresholds, and a Two-Point-Discriminator to estimate static two-point discrimination. Wearing gloves significantly reduced touch sensitivity (p < 0.01), but not two-point discrimination. No difference in touch sensitivity or two-point discrimination was found between different types of gloves. The results of our study suggest that the additional cost of sterile standard surgical gloves can not be justified in terms of touch sensitivity.

Anesthesiology↗
PubMed1996

Needle puncture resistance of surgical gloves, finger guards, and glove liners.

New puncture resistant materials are being developed for health professional use as protection against disease and needle stick injuries. The needle puncture resistance of protective gloves and glove liners from DePuy DuPont Orthopaedics and of finger guards from Zimmer was evaluated using a computerized needle penetration system to determine maximal penetration forces and the penetration work required for taper point and for cutting edge needles to penetrate these membranes. The Medak portion of the Life Liner glove liner and the Spectra portion of the FingGuard finger guard offered remarkable resistance against needle penetration as compared to the other glove liners and gloves tested. The cutting edge needles required considerably less penetration force and work to penetrate the FingGuard and Life Liner than that required with comparable size taper point needles. Because these unique protective materials had a limited distribution over the hand, the surgeon's hand remained susceptible to inadvertent needle puncture. While this protection against needle penetration in the Life Liner and the FingGuard represents an exciting advance in surgery, it is important to emphasize that this development is only one consideration in the selection of surgical gloves.

Biomechanical Phenomena↗