Cleaning with a wet sterile gauze significantly reduces contamination of sutures, instruments, and surgical gloves in an ex-vivo pelvic flexure enterotomy model in horses.

The objective of this study was to investigate whether cleaning surgical materials used to close pelvic flexure enterotomies with a wet sterile gauze will reduce contamination and whether the use of a full thickness appositional suture pattern (F) or a partial thickness inverting (or Cushing) suture pattern (C) would make a difference in the level of contamination. Large colon specimens were assigned to group F or C and divided into subgroups N and G. In group G, a wet sterile gauze was passed over the suture material, another over the instruments, and another over the gloves. In group N, no treatment was applied. The bacterial concentration was measured by optical density (OD) at 24 h. The OD of subgroup CG was lower than that of subgroup CN (P = 0.019). The OD of subgroup FG was lower than that of subgroup FN (P = 0.02). The OD of subgroups CG, CN, FG, and FN was lower than that of the negative control (P < 0.003, P < 0.001, P < 0.001, and P < 0.00). The use of a sterile wet gauze significantly reduced contamination of suture materials. A partial thickness inverting suture pattern did not produce less contamination than a full thickness appositional suture pattern.

L'objectif de la présente étude était d'examiner si le nettoyage du matériel chirurgical utilisé pour fermer les entérotomies de la courbure pelvienne avec une gaze stérile mouillée réduisait la contamination et si l'utilisation d'un patron de suture d'apposition de la pleine épaisseur (F) ou d'un patron de suture inversé d'une épaisseur partielle (ou Cushing) (C) faisait une différence dans le degré de contamination. Des spécimens du gros côlon ont été assignés au groupe F ou C dans les sous-groupes N et G. Dans le groupe G, une gaze stérile mouillée a été passée par-dessus le matériel de suture, une autre par-dessus les instruments, et une autre par-dessus les gants. Dans le groupe N, aucun traitement ne fut effectué. Les concentrations bactériennes ont été mesurées par densité optique (DO) à 24 h. La DO du sous-groupe CG était inférieure à celle du sous-groupe CN (P = 0,019). La DO du sous-groupe FG était inférieure à celle du sous-groupe FN (P = 0,02). Les DO des sous-groupes CG, CN, FG, et FN étaient inférieures à celles des témoins négatifs (P < 0,003, P < 0,001, P < 0,001, et P < 0,00). L'utilisation d'une gaze stérile mouillée a réduit de manière significative la contamination de matériel de suture. Un patron de suture inversé avec épaisseur partielle n'a pas entrainé moins de contamination qu'un patron de suture par apposition avec pleine épaisseur.(Traduit par Docteur Serge Messier).

Performance analysis of exam gloves used for aseptic rodent surgery.

Aseptic technique includes the use of sterile surgical gloves for survival surgeries in rodents to minimize the incidence of infections. Exam gloves are much less expensive than are surgical gloves and may represent a cost-effective, readily available option for use in rodent surgery. This study examined the effectiveness of surface disinfection of exam gloves with 70% isopropyl alcohol or a solution of hydrogen peroxide and peracetic acid (HP-PA) in reducing bacterial contamination. Performance levels for asepsis were met when gloves were negative for bacterial contamination after surface disinfection and sham 'exertion' activity. According to these criteria, 94% of HP-PA-disinfected gloves passed, compared with 47% of alcohol-disinfected gloves. In addition, the effect of autoclaving on the integrity of exam gloves was examined, given that autoclaving is another readily available option for aseptic preparation. Performance criteria for glove integrity after autoclaving consisted of: the ability to don the gloves followed by successful simulation of wound closure and completion of stretch tests without tearing or observable defects. Using this criteria, 98% of autoclaved nitrile exam gloves and 76% of autoclaved latex exam gloves met performance expectations compared with the performance of standard surgical gloves (88% nitrile, 100% latex). The results of this study support the use of HP-PA-disinfected latex and nitrile exam gloves or autoclaved nitrile exam gloves as viable cost-effective alternatives to sterile surgical gloves for rodent surgeries.

Investigation of incidence and risk factors for surgical glove perforation in small animal surgery.

OBJECTIVE: To identify incidence and risk factors for surgical glove perforation in small animal surgery. STUDY DESIGN: Observational cohort study. SAMPLE POPULATION: Surgical gloves (n = 2132) worn in 363 surgical procedures. METHODS: All gloves worn by operative personnel were assessed for perforation at end-procedure using a water leak test. Putative risk factors were recorded by a surgical team member. Associations between risk factors and perforation were assessed using multivariable multi-level random-effects logistic regression models to control for hierarchical data structure. RESULTS: At least 1 glove perforation occurred in 26.2% of procedures. Identified risk factors for glove perforation included increased surgical duration (surgery >1 hour OR = 1.79, 95% CI = 1.12-2.86), performing orthopedic procedures (OR = 1.88; 95% CI = 1.23-2.88), any procedure using powered instruments (OR = 1.93; 95% CI = 1.21-3.09) or surgical wire (OR = 3.02; 95% CI = 1.50-6.05), use of polyisoprene as a glove material (OR = 1.59, 95% CI = 1.05-2.39), and operative role as primary surgeon (OR = 2.01; 95% CI = 1.35-2.98). The ability of the wearer to detect perforations intraoperatively was poor, with a sensitivity of 30.8%. CONCLUSIONS: There is a high incidence of unrecognized glove perforations in small animal surgery.

Efficacy of soaking in 70% isopropyl alcohol on aerobic bacterial decontamination of surgical instruments and gloves for serial mouse laparotomies.

Rodent surgeries in biomedical research facilities are often performed in series. This practice presents many challenges to maintaining aseptic technique between animals. Here, we examined using soaking in 70% isopropyl alcohol for aerobic bacterial decontamination of surgical instruments and gloves used in a series of as many as 10 mouse laparotomy surgeries. These surgeries were performed on mice that were euthanized immediately prior to the procedure. Instruments and gloves were cultured before and after each procedure to determine the presence of aerobic bacterial contamination. To assess the efficacy of the decontamination protocol, culture results were grouped by procedure and then paired (before soak and after soak) for analysis using McNemar test at an α level of 0.05. In addition, by using the Fisher exact test, this modified aseptic method was compared with strict aseptic technique, for which autoclaved instruments and sterile surgical gloves were used for each procedure. In this study, we observed that the modified aseptic technique using 70% isopropyl alcohol soaks pre- vented aerobic bacterial contamination of instruments and gloves for as many as 5 mice.

Study of how frequently surgeons' gloves are perforated during operations.

Surgical gloves were collected after 231 first opinion and referral surgical procedures performed at the University of Liverpool Small Animal Hospital. They were tested for defects by the water load test and the site of any defects was recorded; 10.2 per cent of the gloves had defects, and at least one glove became defective during 51 (22.1 per cent) of the surgical procedures. Significantly more defects occurred during orthopaedic procedures and the likelihood of a defect occurring increased with the duration of the surgical procedure. The majority (78 per cent) of the defects occurred in the gloves worn on the non-dominant hand and 64 per cent of them were in the index finger. The surgeon or assistant was aware of a glove being punctured in only 3.8 per cent of cases.