The effects of chlorination, thickness, and moisture on glove donning efficiency.

Changing gloves more frequently is encouraged, more now than ever given the COVID-19 pandemic. When the donning process has moisture introduced, however, complications can arise, which consumes vital time. Most commonly, gloves undergo a chlorination treatment to reduce glove tack, allowing easier donning. To assess the effects of different chlorination strengths and glove thicknesses on donning, acrylonitrile butadiene gloves were manufactured at two different thicknesses (0.05 and 0.10 mm) with 4 different chlorination treatments: 0, 500, 1000 and 2000 ppm. Six participants were used to assess the time taken to don each of the glove sets with dry and wet hands (16 tests in total). Overall, the thicker gloves took longer to don, due to differences in the material stiffness hindering the donning process. The quickest performance from the chlorinated gloves was noted in the 1000 and 2000 ppm concentrations. Wet conditions also showed significant increases in the donning time.Practitioners Summary: The study was conducted based on the gaps identified in previous literature reviews which revealed the requirement for a greater understanding of glove donning process. It was found a stronger chlorination was detrimental when the hands were wet, but better when dry. Thicker gloves were also found to be detrimental. Abbreviations: PPE: personal protective equipment; NBR: acrylonitrile butadiene rubber; NRL: natural rubber latex; EN: European standards; s: seconds; Ts: tensile strength; Fb: force at break; T: thickness; Eb: elongation at break; HSD: honest significant difference; FTIR: Fourier transform infrared; covid-19: coronavirus disease 2019.

Glove perforation rate with orthopedic gloving versus double gloving technique in tibial plateau leveling osteotomy: A randomized trial.

In this randomized, prospective study, perforation rates, glove change rates, and cost between orthopedic gloves (n = 227) and double gloving with standard latex surgical gloves (n = 178) worn in tibial plateau leveling osteotomy procedures were compared. Gloves were collected from the surgeon and surgical resident after procedures and were tested for perforations with a standardized water leak test, as described by the American Society for Testing and Materials International. No statistically significant difference was found between the perforation rate using orthopedic gloving and double gloving techniques (P = 0.629) or the rate at which gloves were changed (P = 0.146). Orthopedic gloving was 2.1 times more costly than double gloving but they may be preferred by surgeons for dexterity and comfort.

Taux de perforation des gants avec le gantage orthopédiquepar oppositionà une technique de double gantage pour l'ostéotomie de nivellement du plateau tibial : un essai randomisé. Dans cette étude prospective randomisée, les taux de perforation, les taux de changement des gants et le coût des gants orthopédiques (n = 227) et du double gantage avec des gants de chirurgie au latex standard (n = 178) portés dans les interventions d'ostéotomie du nivellement du plateau tibial ont été comparés. Les gants ont été recueillis auprès du chirurgien et du résident en chirurgie après les interventions et ils ont été testés pour les perforations à l'aide d'un test de fuite normalisé, tel que décrit par l'American Society for Testing and Materials International. Aucune différence statistique n'a été constatée entre le taux de perforation à l'aide des techniques de gants orthopédiques et du double gantage (P = 0,629) ou le taux de remplacement des gants (P = 0,146). Le gantage orthopédique était 2,1 fois plus cher que le double gantage mais il peut être privilégié par les chirurgiens car il offre plus de dextérité et de confort.(Traduit par Isabelle Vallières).

The impact of the use of different types of gloves and bare hands for preparation of clean surgical instruments.

Objectives: to determine if there are differences on the safety of the preparation of clean surgical instruments using different types of gloves and bare hands and evaluate the microbiological load of these preparations without gloves. Method: laboratory procedure with a pragmatic approach, in which the samples were handled with different types of gloves and bare hands. In addition, cytotoxicity assays were carried out by means of the agar diffusion method. Further samples were subjected to microbiological analysis after being handled without gloves. Results: none of the samples showed cytotoxic effect. All microbiological cultures showed growth of microorganisms, but no microorganism has been recovered after autoclaving. Conclusion: there were no differences in the cytotoxic responses regarding the use of different types of gloves and bare hands in the handling of clean surgical instruments, which could entail iatrogenic risk. It is noteworthy that the use of gloves involves increase in the costs of process and waste generation, and the potential allergenic risk to latex.

The impact of the use of different types of gloves and bare hands for preparation of clean surgical instruments / O impacto do uso de diferentes tipos de luvas e das mãos nuas no preparo do instrumental cirúrgico limpo / El impacto del uso de diferentes tipos de guantes y de las manos desnudas en la preparación del instrumental quirúrgico limpio

ABSTRACT Objectives: to determine if there are differences on the safety of the preparation of clean surgical instruments using different types of gloves and bare hands and evaluate the microbiological load of these preparations without gloves. Method: laboratory procedure with a pragmatic approach, in which the samples were handled with different types of gloves and bare hands. In addition, cytotoxicity assays were carried out by means of the agar diffusion method. Further samples were subjected to microbiological analysis after being handled without gloves. Results: none of the samples showed cytotoxic effect. All microbiological cultures showed growth of microorganisms, but no microorganism has been recovered after autoclaving. Conclusion: there were no differences in the cytotoxic responses regarding the use of different types of gloves and bare hands in the handling of clean surgical instruments, which could entail iatrogenic risk. It is noteworthy that the use of gloves involves increase in the costs of process and waste generation, and the potential allergenic risk to latex.

RESUMO Objetivos: determinar se existe diferenças na segurança do preparo de instrumentais cirúrgicos relacionada ao uso de distintos tipos de luvas e das mãos nuas no preparo, e avaliar a carga microbiológica destes preparados sem luvas. Método: experimento laboratorial com abordagem pragmática, onde amostras foram manipuladas com diferentes tipos de luvas e com as mãos nuas, elaborado teste de citotoxicidade por meio da difusão em ágar. Outras Amostras sofreram análise microbiológica após serem manipuladas sem luvas. Resultados: nenhuma das amostras apresentou efeito citotóxico. Todas as culturas microbiológicas apresentaram crescimento de microrganismos, embora nenhum microrganismo tenha sido recuperado após a autoclavação. Conclusão: não houve diferenças nas respostas citotóxicas relacionadas ao uso de diferentes tipos de luvas e das mãos nuas na manipulação do instrumental cirúrgico limpo que sinalizasse risco de iatrogenia. Ressalta-se que o uso de luvas implica em aumento dos custos do processo e da geração de resíduos, além do potencial risco alergênico ao látex.

RESUMEN Objetivos: determinar si existen diferencias en la seguridad de la preparación del instrumental quirúrgico relacionadas con el uso de diferentes tipos de guantes y de las manos desnudas y evaluar la carga microbiológica de estos preparados sin guantes. Método: experimento de laboratorio con enfoque pragmático, en el que las muestras fueron manejadas con diferentes tipos de guantes y las manos desnudas. Además, un ensayo de citotoxicidad se llevó a cabo mediante el método de difusión en agar. Otras muestras fueron sometidas a análisis microbiológico después de haber sido manipuladas sin guantes. Resultados: ninguna de las muestras presentó efecto citotóxico. Todos los cultivos microbiológicos mostraron crecimiento de microorganismos, pero ningún microorganismo ha sido recuperado después de la esterilización en autoclave. Conclusión: no hubo diferencias en las respuestas citotóxicas con respecto al uso de diferentes tipos de guantes y de las manos desnudas en el manejo del instrumental quirúrgico limpio, lo que podría conllevar riesgo de yatrogenia. Es de destacar que el uso de guantes implica un aumento de los costos del proceso y la generación de residuos, además del potencial riesgo alergénico al látex.

Factors that influence the selection of sterile glove brand: a randomized controlled trial evaluating the performance and cost of gloves.

PURPOSE: To determine whether glove use modifies tactile and psychomotor performance of health care providers when compared with no glove use and to evaluate factors that influence the selection of sterile glove brand. METHODS: Forty-two anesthesia providers (nine anesthesiologists, seven nurse anesthetists, 20 residents, six student nurse anesthetists) enrolled in and completed this cross-over randomized trial from May 2010 until August 2011. Participants underwent standardized psychomotor testing while wearing five different types of protective gloves. Assessments of psychomotor performance included tactile, fine motor/dexterity, and hand-eye coordination tests. Subjective ratings of glove comfort and performance were reported at the completion of each glove trial. The manufacturer's suggested retail price was collected for each glove tested. RESULTS: There were statistically significant differences in touch sensitivity for all nerve distributions, with all glove types resulting in less sensitivity than a bare hand. When compared with the non-sterile glove, only the thickest glove tested (Ansell Perry Orthopaedic) was found to have less touch sensitivity. Fine motor dexterity testing revealed no statistically significant differences in time to completion amongst glove types or bare handed performance. In hand-eye coordination testing across treatment conditions, the thickest glove tested (Ansell Perry(®) Orthopaedic) was the only glove to show a statistically significant difference from a bare hand. There were statistically significant differences in glove comfort ratings across glove types, with latex-free, powder-free (Cardinal Esteem(®)), and latex powder-free (Mölnlycke-Biogel(®)) rated highest; however, there were no statistically significant differences in subjective performance ratings across glove types. CONCLUSIONS: Given the observed similarities in touch sensitivity and psychomotor performance associated with five different glove types, our results suggest that subjective provider preferences, such as glove comfort, should be balanced against material costs.

Effect of five brands of latex gloves on the setting time of polyvinyl siloxane putty impression materials.

Addition silicone impression materials have been used as impression material for more than 20 years. Although they are among the most expensive impression materials, they became popular during the past decade as they have excellent physical properties. Prevention of infection is an important aspect in dental treatment since dental professionals are routinely exposed to the wide variety of microorganisms present in saliva. Gloves are the most common protective measure used during dental treatment. The gloves are mostly made of latex. In this study, we examine how the setting time of three types polyvinyl putty materials were affected by the use of five different brands of latex gloves and one brand of vinyl gloves. Each material was first mixed without wearing gloves according to the manufacturer's instructions. After the stipulated mixing time, the setting time was measured using the Vicat needle. The setting time is measured from the time of mixing till the time that the needle does not produce any indentation on the surface of the material. The putty material was then mixed with gloved hands (using the five different brands of latex gloves in turn) and the setting time was measured. Then the material was mixed with washed gloved hands, and the setting time was measured again. Finally, the material was mixed with vinyl gloved hands and the setting time was measured. The following conclusions were drawn from the study: Reprosil and Express showed significant variation in the setting time with the latex gloved hands.There was no significant variation in the setting time when material was mixed with unwashed vs washed gloved hands.Vinyl gloves did not significantly affect the setting time of any of the putty impression materials.

Comparison of 4 different types of surgical gloves used for preventing blood contact.

BACKGROUND: Needlestick injuries are always associated with a risk of infection, because these types of punctures may expose healthcare workers to a patient's blood and/or body fluids. OBJECTIVE: To compare the efficacy of 4 different types of surgical gloves for preventing exposure to blood as a result of needlestick injury. METHODS: For simulation of needlestick injury, a circular sample of pork skin was tightened onto a bracket, and a single finger from a medical glove was stretched over the sample. First, a powder-free surgical glove with a gel coating was used to test blood contact. Second, a glove with a patented puncture indication system was used to test blood contact with a double-gloved hand. Third, 2 powder-free latex medical gloves of the same size and hand were combined for double gloving, again to test blood contact. Finally, we tested a glove with an integrated disinfectant on the inside. The punctures were carried out using diverse sharp surgical devices that were contaminated with (99)Tc-marked blood. The amount of blood contact was determined from the transmitted radioactivity. RESULTS: For the powder-free surgical glove with a gel coating, a mean volume of 0.048 microL of blood (standard error of the mean [SEM], 0.077 microL) was transferred in punctures with an automated lancet at a depth of 2.4 mm through 1 layer of latex. For the glove with an integrated disinfectant on the inside, the mean volume of blood transferred was 0.030 microL (SEM, 0.0056 microL) with a single glove and was 0.024 microL (SEM, 0.003 microL) with 2 gloves. For the glove with the patented puncture indication system, a mean volume of 0.024 microL (SEM, 0.003 microL) of blood was transferred. CONCLUSIONS: Double gloving or the use of a glove with disinfectant can result in a decrease in the volume of blood transferred. Therefore, the use of either of these gloving systems could help to minimize the risk of bloodborne infections for medical staff.

[Chemical resistance of latex gloves]. / Efficacia protettiva dei guanti di latice nei confronti degli agenti chimici.

Dermal chemical risk is represented by the chemicals with irritant, caustic and sensitization properties or that can produce toxic effects after penetration through the skin. During the last few years the interest for the effective protecting ability of gloves progressively is increased in parallel with their use. Penetration of chemicals through the protecting material does not always turn out visible. That has led to the development of test standardizes. In 1989 the EC adopted two Directives in the field of the characteristics of protection devices defining certification procedures (89/686/EEC) and characteristics demanded for the use of protection devices at the workplace (89/656/EEC). When the European Standards are accepted from the CEN they exist in rough draft shape (prEN), losing the prefixed one pr- when they are approved by all the EC member Countries. A number of EN for protection gloves have been proposed by CEN/TC 162 regarding methods for testing the resistance to penetration/permeation of chemicals and other characteristics. However in these protocols some limitations were found, since not necessarily they represent the real using conditions. In general an ideal protecting material against the chemicals does not exist because what is effective to a specific compound does not effectively protect from an other. Latex is not commonly considered a very chemical resistant material and therefore its use in such sense is limited However the low cost and the spread of latex gloves in particular in Public Health often make them easy available at workplace and therefore used in several situations.

Avaliação dos testes empregados para detecção de perfurações em luvas cirúrgicas / Evaluation of the tests used for detection of perforations in surgical gloves

A integridade das luvas cirúrgicas durante procedimentos de Cirurgia Bucal pode sofrer avarias. Dentro desse contexto, a reutilização das mesmas, seja para procedimentos invasivos ou não invasivos, prática ainda usada em alguns setores de saúde, que alegam ganho financeiro devido a poucos recursos disponíveis, é um risco desnecessário para o profissional e para o paciente. Assim, esse estudo teve como objetivo avaliar a eficiênciados testes de inspeção visual, auditiva e tátil, bem como variações dessas técnicas, empregados na detecçãode perfurações em luvas cirúrgicas. Quarenta pares de luvas cirúrgicas receberam perfurações com diferentesmateriais pérfuro-cortantes e foram submetidos a diferentes testes para avaliar a eficiência dos mesmos na detecção das perfurações. Os resultados mostram que os testes comumente utilizados para verificação de perfurações em luvas cirúrgicas, não são capazes de detectar todas as perfurações. Os achados demonstramque está totalmente contra-indicada a reutilização de luvas, sendo um risco desnecessário para o profissional e o paciente.

The integrity of the surgical gloves during procedures of Oral Surgery can suffer damages. Inside of this context, reuse of same for invasive or not invasive procedures, practice used in some health sectors who makeuse of it justify such practice through financial benefits an unnecessary risk both to the professional and the patient.Thus, this study aimed to evaluate the effectiveness of the visual, auditory and tactile, as well as variations of these techniques, inspection tests used in thedetection of perforations in surgical gloves. Forty pairs of surgical gloves have holes with different perforationsmaterials and were subjected to various tests to assess the efficiency of them in detection of holes. The results show that the tests commonly used about to verification of perforations in surgical gloves, are not capable of detectingall the perforations. The finds demonstrate that is fully not indicated the reuse of gloves, being an unnecessary risk about to the professional and the patient.

Safer surgical gloves: evaluation and implementation.

In 2003 the Scottish Health Service Central Legal Office was consulted on the requirement to supply an alternative to natural rubber latex gloves for healthcare professionals within NHS Lothian University Hospitals Trust. Counsel stated that as latex is now accepted as being hazardous to health, employers must prove the statutory defence in Regulation 7(1) of the Control ofSubstances Hazardous to Health Regulations (HSE 2002). Counsel also stated that, as there are now adequate alternatives to latex gloves, NHS employers would have an indefensible position if no attempt was made to supply alternatives.

Monomer permeability of disposable dental gloves.

STATEMENT OF PROBLEM: Studies have suggested that monomers may be able to permeate dental gloves. PURPOSE: This study examined the permeability of disposable dental gloves to 6 kinds of dental monomers. MATERIAL AND METHODS: The permeability of 6 kinds of dental monomers (methyl methacrylate [MMA], 2-hydroxyethyl methacrylate [HEMA], triethyleneglycol methacrylate [TEGDMA], ethyleneglycol dimethacrylate [EGDMA], urethane dimethacrylate [UDMA], and Bis-glycidyl methacrylate [Bis-GMA]) through 5 kinds of dental gloves (latex, powder-free latex, coated latex, polychloroprene, and polyvinyl chloride) was examined for up to 180 minutes at 37 degrees C. The fingers of unused gloves without pin holes were cut and used in the experiments. Five specimens per test group were examined. One type of monomer was poured into each finger and dipped in ethanol. The ethanol for extraction was measured by a spectrophotometer at a wavelength of 210 nm, and the results were analyzed by analysis of variance and the Kruskal-Wallis test (P<.05). RESULTS: Four of the monomers tested (MMA, HEMA, TEGDMA, and EGDMA) permeated the gloves tested, whereas 2 (UDMA and Bis-GMA) did not (P>.01). The amount of monomers permeating the latex in 10 minutes was 0.8 +/- 0.6, 0.6 +/- 0.6, 0.07 +/- 0.1, 0.07 +/- 0.1, 0.1 +/- 0.1 and 0.06 +/- 0.1 microL/mL for MMA, HEMA, EGDMA, TEGDMA, UDMA, and Bis-GMA, respectively. The amount of permeated monomer was then increased in relation to the examination time, and in MMA and HEMA, permeation occurred rapidly during the initial 60 minutes at 3 times the 10-minute values, then continued gradually and linearly. The polyvinyl chloride glove showed the greatest monomer permeability. Two-way analysis of variance showed significant correlations between MMA, HEMA, EGDMA or TEGDMA and UDMA or Bis-GMA (P<.01). Statistical significance was shown between polyvinyl chloride and latex, powder-free latex, coated latex or polychloroprene (P<.01). However, there was no significant relation between any kind of dental monomer and any kind of dental glove. CONCLUSION: Within the limitations of this study, 4 of the monomers tested permeated all of the gloves tested.

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.

Glove leakage rates as a function of latex content and brand: caveat emptor.

HYPOTHESIS: That water leakage rates and protection against blood-borne pathogens should not vary as a function of latex content among Food and Drug Administration-approved gloves, allowing avoidance of unnecessary latex exposure. DESIGN AND METHODS: Eighteen different glove types were purchased and tested using the American Society for Testing Methods Standard Test for Detecting Holes in medical gloves, which involves mounting the glove on a plastic tube, pouring a liter of tap water into the glove, and visually inspecting the glove initially and after 2 minutes. Half of the gloves were tested straight from the package and half after a standardized manipulation. SETTING: A university hospital. RESULTS: Eleven sterile glove types (5 high latex content, 4 low latex content, and 2 nonlatex content), and 7 nonsterile examination glove types (2 high latex content, 2 low latex content, and 3 nonlatex content) were tested (total tested, 3720 gloves). Leakage rates were greater for examination than for surgical gloves (relative risk [RR], 1.41, 95% confidence interval [CI], 1.01-1.96), for manipulated than for unused gloves (RR, 2.89, 5% CI, 1.98-4.22), and for low latex content surgical gloves (RR, 2.58, 95% CI, 1.35-4.92) or nonlatex content surgical gloves (RR, 4.93, 95% CI, 2.35-10.32) than for high latex content surgical gloves. Significant differences were observed among low latex content surgical gloves (P

[Patients, surgeons and surgical gloves]. / Malades, chirurgiens et gants chirurgicaux.

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.

The protective effect of a cut-resistant glove liner. A prospective, randomised trial.

We performed a prospective, randomised study comparing the rates of glove perforation using double latex gloving with or without a disposable protective glove liner (Paraderm) on 118 patients undergoing primary or revision arthroplasty of the hip or knee by one surgeon (FRH). The patients were randomly allocated into two groups: in group 1 an inner and outer pair of latex gloves were worn as double gloves and in group 2 the glove liner was worn between the two latex gloves. There was glove perforation in at least one outer glove in 99 operations (84%). The operating surgeon was aware of the perforation in 21 of these. There were 22 perforations of the inner glove. Group 1 had a significantly higher perforation rate per operation (p < 0.05) than group 2. Our findings show that protective glove liners significantly reduce the rate of perforation of the inner glove during hip and knee arthroplasty.

Improving glove barrier effectiveness.

Perioperative staff members depend on surgical gloves to prevent disease transmission between themselves and patients, but these gloves frequently fail during use. Three approaches can make surgical gloves more effective barriers: preventing glove failures, monitoring glove integrity, and improving glove quality. Failure prevention includes modifying surgical techniques, improving instruments and equipment, streamlining teamwork, selecting the most appropriate gloves, double gloving, and performing preventive glove changes. Glove integrity monitoring can be performed visually or by feel, by wearing glove pairs with color-puncture indicators, or by using electronic monitoring devices. Glove quality improvements must be accompanied by testing methods that reflect in-use conditions. A glove rating system that is based on in-use performance may enhance glove safety substantially.