A method of removing starch powder from surgeons' gloves.
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A method of washing the outside of surgeons' gloves with cetrimide is described. Experiments on animals showed that the method resulted in a considerable reduction in the amount of intraperitoneal contamination by starch powder. (+info)
Starch dermatitis: evidence of immunogenicity of surgical glove powder in the guinea-pig.
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Guinea-pigs immunized by nuchal inoculation of starch glove powder emulsified with Freund's complete adjuvant showed increased thickening of the ear erythema and monoculear inflammation after local injection of 0.1 mg starch compared with similarly treated control animals inoculated with saline and Freund's complete adjuvant. The responses in the ear of the immunized animals were most pronounceed 3-4 weeks after immunization and 24-72 h after local challenge. It is suggested that the inflammatory response in the immunized guinea-pig has 2 components: reaction to a primary irritant in the glove powder and delayed hypersensitivity to an unidentified component of the glove powder. (+info)
An unusual case of a postoperative bone cyst.
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We describe an unusual case of a postoperative bone cyst resulting from a retained fragment of surgical glove. We highlight some of the problems associated with gloves and suggest ways of safeguarding against similar complications. (+info)
Effectiveness of the hands-free technique in reducing operating theatre injuries.
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BACKGROUND: Operating theatre personnel are at increased risk for transmission of blood borne pathogens when passing sharp instruments. The hands-free technique, whereby a tray or other means are used to eliminate simultaneous handling of sharp instruments, has been recommended. AIMS: To prospectively evaluate the effectiveness of the hands-free technique in reducing the incidence of percutaneous injuries, contaminations, and glove tears arising from handling sharp instruments. METHODS: For each of 3765 operations carried out in main and surgical day care operating theatres in a large urban hospital, over six months, circulating nurses recorded the proportion of use of the hands-free technique during each operation, as well as other features of the operation. The hands-free technique, considered to be used when 75% or more of the passes in an operation were done in this way, was used in 42% of operations. The relative rate of incidents (percutaneous injuries, contaminations, and glove tears) in operations where the hands-free technique was used and not used, with adjustment via multiple logistic regression for the different risk profiles of the two sets of operations, was calculated. RESULTS: A total of 143 incidents (40 percutaneous injuries, 51 contaminations, and 52 glove tears) were reported. In operations with greater than 100 ml blood loss, the incident rate was 4% (18/486) when the hands-free technique was used and 10% (90/880) when it was not, approximately 60% less. When adjusted for differences in type and duration of surgery, emergency status, noisiness, time of day, and number present for 75% of the operation, the reduction in the rate was 59% (95% CI 23% to 72%). In operations with less than 100 ml blood loss, the corresponding rates were 1.4% (15/1051) when the hands-free technique was used and 1.5% (19/1259) when it was not used. Adjustment for differences in risk factors did not alter the difference. CONCLUSIONS: Although not effective in all operations, use of the hands-free technique was effective in operations with more substantial blood loss. (+info)
Use of sterile gloves in the treatment of simple wounds.
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A short cut review was carried out to establish whether the use of sterile gloves during the treatment of simple wounds reduces infections. Altogether 48 papers were found using the reported search, but none presented any evidence to answer the clinical question. More research is needed in this area and, in the mean time, local advice should be followed. (+info)
Application of a gloved-hand model for multiparameter measurements of skin-degerming activity.
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The application of an established gloved-hand model to multiparameter measurements of skin-degerming activity is described. In particular, appropriate experimental designs are illustrated which allow characterization of performance of topical skin-cleansing preparations in terms of rapid, sustained, cummulative, and persistent skin-degerming effects on the hand. Single-contact studies were used to define the degerming activity profiles of selected commercial surgical scrub preparations, and to establish the optimal post-treatment sampling interval for individual preparations. Rapid and sustained skin-degerming effects were measured and contrasted. Rapid skin-degerming activity, iodophor preparation. Sustained skin-degerming activity, namely, that occurring on the gloved hand during a postcontact interval, was shown and characterized for two hexachlorophene preparations. Multiple-contact studies with a 3% hexachlorophene preparations were used to illustrate cummulative and persistent skin-degerming effects. Cummulative skin-degerming activity was demonstrated in terms of progressive bacterial reductions after repeated contacts within a single day. Presistent skin-degerming activity was shown in terms of the profile of daily pretreatment bacterial counts after multiple contacts over successive days. Uniformity of treatment response was established for a broad range of pretreatment bacterial counts extending from approximatley log 4 to log 7 per hand. The importance of pretreatment bacterial count measurement and of adequate neutralization of hand extract samples is stressed. A randomized-hand experimental design is discussed relative to its versatility and amenability to statistical analysis. (+info)
Does sterile or nonsterile technique make a difference in wounds healing by secondary intention?
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After observing inconsistencies in care of acute surgical wounds healing by secondary intention and reviewing the potential cost savings of implementing clean dressing change technique policies, surgical nurses at a university-based medical center monitored supply usage and infection rates of these wounds using a nonexperimental, longitudinal study design. Staff from two acute care surgical units provided data for 3 months before and 3 months after standardization of wound care to a clean wound care technique. All adult patients requiring dressing changes three times per day with normal saline moistened gauze of their open surgical wound(s) participated in the study. Before changing the wound care procedures, nine (9) of 1,070 (0.84%) admissions to the two surgical units had a surgical site infection. During the 3 months following implementation of clean wound care protocols, eight (8) surgical site infections were documented in 963 admissions (rate.83%). Dressing supply costs were $380 less. In this study, using nonsterile wound care procedures for wounds healing by secondary intention did not negatively impact infection rates and saved supply costs. (+info)
Lung accumulations of eosinophil granulocytes after exposure to cornstarch glove powder.
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Starch is a main component of wheat flour, which, besides being an occupational allergen can also induce irritative symptoms in the airways. A purified starch product (cornstarch glove powder) was used to investigate whether starch alone could induce airway inflammation. The aim of the study was to investigate a role for starch in wheat flour-induced airway inflammation. Ten healthy individuals were exposed to cornstarch glove powder in a whole-body exposure chamber. Bronchoscopy with bronchoalveolar lavage (BAL) was performed 2-3 weeks before and 1 day after exposure, and the BAL cells were counted differentially. In addition, the expression of activation, adhesion and subset markers on alveolar macrophages and BAL T-cells were investigated using flow cytometry. A three-fold increase in BAL cell concentrations was found, with a selective accumulation and activation of eosinophilic granulocytes, as well as an influx of nonactivated monocytes and polyclonal CD4+ T-cells into the airways. The results show that inhalation of cornstarch glove powder leads to the development of a subclinical inflammation in the airways, with an accumulation of eosinophilic granulocytes. The authors suggest that such exposure may be an interesting model for studying factors contributing to lung accumulations of eosinophil granulocytes in humans. (+info)