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PubMedDate not supplied

Synthetic surgical gloves.

Surgical gloves are used by healthcare workers primarily to minimize the transmission of bloodborne pathogens and other potential infectants. Gloves made of synthetic materials are getting more attention with the increasing prevalence of allergies to natural rubber latex (NRL) among patients and medical staff. However, synthetic gloves are perceived by some people as providing less protection and being less comfortable than NRL gloves. In this study, we evaluated eight models of synthetic surgical gloves from six manufacturers. We examined their barrier effectiveness (that is, their resistance to viral penetration, resistance to puncture, and strength) durability, and comfort and compared these characteristics to those of NRL gloves. We found that all the gloves offered good barrier protection, but that their level of comfort varied widely. Three gloves were rated Preferred, three were Acceptable, and the remaining two gloves were Not Recommended.

Evaluation Studies as Topic↗
PubMed2002

Synthetic surgical gloves.

Surgical gloves are used by healthcare workers to protect them against bloodborne pathogens and other potential infectants and to prevent wound contamination in patients. In response to the increasing prevalence of allergies to natural rubber latex (NRL) among patients and medical staff, the trend toward purchasing gloves made of synthetic materials is on the rise. However, latex continues to dominate the market, and some people still perceive synthetic gloves as providing less protection and being less comfortable than NRL gloves. For this Update Evaluation, we present our findings for three newly evaluated glove models from three manufacturers and summarize our findings for the seven previously evaluated models that are still on the market. (Our earlier Evaluation was published in the February-March 2000 Health Devices.) As in the previous Evaluation, our ratings are based on the gloves' barrier effectiveness--that is, their resistance to viral penetration and their durability--and comfort. We also compared these characteristics of the synthetic gloves to those of NRL gloves. We found that all the evaluated gloves offer adequate barrier protection but that their level of comfort varies considerably. We rate three models Preferred, five models Acceptable, and two models Not Recommended.

Decision Making, Organizational↗
PubMed2000

Detection of surgical glove integrity.

Surgical glove integrity is essential for universal precautions; glove safety is verified by the water load test (WLT). Concerns regarding glove injury have prompted newer testing methodologies, including electrical conductance testing (ECT); however, the sensitivities of these tests are not known. We compared the sensitivity of WLT and ECT in detecting glove needle-stick injury in two commonly used brands of surgical gloves. Punctures were made with hollow-bore and solid surgical needles of various configurations. The WLT failed to detect glove holes from the smallest-caliber needles and only detected the injury in 60 per cent for the largest caliber. The ECT provided a graded index of glove injury in all holes made by both solid surgical needles and hollow-bore needles. The WLT is a poor test for clinical defects in latex surgical gloves; the ECT is significantly more sensitive and provides a gauge of the cross-sectional area of the defect. Interbrand differences in self-sealing properties of surgical gloves were evidenced and may be clinically relevant after glove perforation.

Electric Conductivity↗
PubMed1992

Surgical glove powder and intraperitoneal adhesion formation. An appeal for the use of powder-free surgical gloves.

Intraperitoneal adhesion formation is a major cause of infertility and/or intestinal obstruction. Among the many well-known aetiological factors responsible for peritoneal inflammatory reaction is surgical glove powder; for example, cornstarch powder. A study was undertaken on 30 rats to determine whether cornstarch powder caused intraperitoneal adhesions. The rats were randomised into two groups under laboratory conditions. Laparotomies were performed on all the rats and trauma inflicted to the right uterine horn. The study group received cornstarch powder suspended in normal physiological salt solution intraperitoneally, and the control group received only normal physiological salt solution. Peritoneal adhesions were evaluated after 2 weeks and statistically analysed with a t-test and 95% confidence intervals. The study group showed a statistically significantly higher incidence of intraperitoneal adhesions (P = 0.0003). It is concluded that cornstarch, as used on surgical gloves, caused peritoneal adhesions and should therefore be removed before surgery. Powder-free gloves are more suitable for preventing adhesion formation.

Animals↗
PubMed2001

Implementing a nonlatex surgical glove study in the OR.

Sterile surgical gloves are used to protect patients and health care workers (HCWs) from infection during surgery and to shield HCWs from exposure to bloodborne pathogens. Based on increased reports of latex allergy, many HCWs now use nonlatex surgical gloves as a substitute for natural rubber gloves. Little is known, however, about the performance of nonlatex gloves in surgery. This article describes a study that currently is being performed to test the barrier performance of nonlatex surgical gloves after they have been used in surgery and to determine HCW satisfaction. To date, 12,703 latex and nonlatex gloves from all surgical services have been collected and tested for barrier quality. This article describes the project and challenges encountered by the collaborative team of perioperative staff members and nurse researchers as they collect data.

Consumer Behavior↗
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↗
PubMed2000

[Patients, surgeons and surgical gloves].

Consumption of surgical gloves in progressing constantly. All proposed products do not have the same qualities in terms of protection, comfort, and safety for the surgeon, the surgical team and the patient. Latex is the basic material used to manufacture surgical gloves even if it does raise the problem of side-effects and requires use of starch powder for lubrification. The surgeon should be aware of the different products and participate in choosing this indispensable tool. There is a general and advisable trend to using non-powdered gloves.

Equipment Design↗
PubMed2003

[The advent of surgical gloves].

The advent of surgical gloves had a double evolution. Evolution of the material: cecum of a sheep, cotton, silk, leather, rubber. Originally introduced to protect theatre staff's hands from corrosive solutions, subsequent use was to protect the patient from contamination by theatre staff. Many surgeons contributed to the evolution of the surgical gloves. The use of gloves was truly part of an evolutionary process than a discovery. The turning of surgical gloves is now incontestable, and their use more and more important. Surgical gloves must secure a crossing protections between surgeon and patient.

Caustics↗
PubMed1992

The mechanisms and risks of surgical glove perforation.

Intact surgical gloves are a barrier to hepatitis B virus and human immunodeficiency virus (HIV) but once perforated during surgery they cannot sustain adequate defence. This study examines the rate of glove perforations during surgery at a District General Hospital. In total, 275 pairs of gloves were collected from 100 consecutive operations. In the 43% of gloves that had been damaged 200 perforations were recorded. The mean rate per operation in the surgeon's gloves was 1.18. Injuries to the non-dominant index finger were significantly higher than injuries to other parts of the hand. Injuries occurred particularly during manipulation of the needles and at wound closure. Consultants were more likely to have glove perforation than juniors. Operations requiring manipulation of instruments deep within the wound had a higher rate than those on the surface. The results of the study indicate that a surgeon risks more than one hepatitis B infection per lifetime and that at least one in 1500 surgeons is likely to be infected by HIV during the next 35 years.

Equipment Failure↗
PubMed1996

[Perforations and porosity of surgical gloves. Frequency, mechanism, risk].

Surgical gloves constitute part of the most exposed barrier material, as one half of accidental exposures to blood in the exposures to blood in the operating room involve the hands. Approximately 15% of gloves tested at the end of the operation were found to be perforated. Double gloving lowers this rate to 5% with apparently acceptable tolerance for surgeons. Although surgical glove are initially impermeable to various viruses, the porosity increases with the duration of use. This porosity is related to hydratation and deformation of latex fibres. The maintenance of a good barrier function of surgical gloves requires regular changing, at least hourly, in the current state of knowledge.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Comparison of diagnostic methods in latex surgical glove contact urticaria.

Surgical rubber gloves contain allergens derived from natural rubber latex which may sensitize, causing contact urticaria and even systemic reactions. We examined 15 hospital employees allergic to latex surgical gloves, using various skin tests and RAST, to determine the most reliable diagnostic method and to investigate coexistent allergy to glove powder and rubber chemicals. Prick testing using a stock solution made from one brand of latex glove yielded positive (2+ to 4+) reactions in all 15 employees: 8 retained positive reactions at a 1/10 dilution, 1 at 1/100 and 4 at 1/1000. A prick test using rubber-tree sap (Hevea brasiliensis) was positive in 12/15 employees and a scratch-chamber test using crushed rubber-tree leaf was positive in 13/15. A latex glove use test was positive in 12/13 employees and a latex RAST detected measurable amounts of specific IgE in 8/15. No positive prick test reactions were obtained using glove powder. On patch testing, 2/15 employees showed delayed allergy to rubber chemicals but no immediate reactions were detected. The present results indicate that in addition to the use test, prick testing with a stock solution prepared from latex surgical gloves is an adequate test method for routine practice when diagnosing latex glove contact urticaria. The correlation between prick tests and whole glove use tests was good, but latex RASTs yielded some negative results.

Adult↗
PubMed1993

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

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

Adult↗
PubMed1989

Surgical glove failure rate.

Surgical gloves were collected after day-time operations for a 4-week period. Glove punctures were located by inflating each glove with compressed air and immersing the inflated glove in water. During the period of the study 681 surgical operations were performed. A total of 3790 gloves was collected, 334 gloves (8.8%) had perforations at the end of the surgical procedure. Defects occurred in one or more gloves in 32.0% of all operations.

Equipment Failure↗
PubMed1994

Dispensing surgical gloves onto the open surgical gown pack does not increase the bacterial contamination rate.

In implant surgery air and surface contamination have become important factors in post-operative wound infection. We established the rate of contamination of surgical gown packs and found that dropping gloves onto the open gown pack prior to scrubbing had no effect on it. Ninety-six contact plates were used for this study, which was carried out during clean orthopaedic operations in one operating room. The overall rate of contamination was 65%. Most of the contaminants were skin commensals. The rate of contamination was 67% when gloves were dropped onto the gown pack compared with 63% when opened and presented to the scrubbed and gowned theatre staff. However this difference was statistically not significant. The high rate of contamination was probably due to the gown packs having been left opened for too long. This delay arose because each gown pack had three gowns and would have been avoided if single gown packs had been used.

Environmental Microbiology↗
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↗
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↗