Evaluation of an antimicrobial surgical glove to inactivate live human immunodeficiency virus following simulated glove puncture.

BACKGROUND: Percutaneous injuries associated with cutting instruments, needles, and other sharps (eg, metallic meshes, bone fragments, etc) occur commonly during surgical procedures, exposing members of surgical teams to the risk for contamination by blood-borne pathogens. This study evaluated the efficacy of an innovative integrated antimicrobial glove to reduce transmission of the human immunodeficiency virus (HIV) following a simulated surgical-glove puncture injury. METHODS: A pneumatically activated puncturing apparatus was used in a surgical-glove perforation model to evaluate the passage of live HIV-1 virus transferred via a contaminated blood-laden needle, using a reference (standard double-layer glove) and an antimicrobial benzalkonium chloride (BKC) surgical glove. The study used 2 experimental designs. In method A, 10 replicates were used in 2 cycles to compare the mean viral load following passage through standard and antimicrobial gloves. In method B, 10 replicates were pooled into 3 aliquots and were used to assess viral passage though standard and antimicrobial test gloves. In both methods, viral viability was assessed by observing the cytopathic effects in human lymphocytic C8166 T-cell tissue culture. Concurrent viral and cell culture viability controls were run in parallel with the experiment's studies. RESULTS: All controls involving tissue culture and viral viability were performed according to study design. Mean HIV viral loads (log(10)TCID(50)) were significantly reduced (P < .01) following passage through the BKC surgical glove compared to passage through the nonantimicrobial glove. The reduction (log reduction and percent viral reduction) of the HIV virus ranged from 1.96 to 2.4 and from 98.9% to 99.6%, respectively, following simulated surgical-glove perforation. CONCLUSION: Sharps injuries in the operating room pose a significant occupational risk for surgical practitioners. The findings of this study suggest that an innovative antimicrobial glove was effective at significantly (P < .01) reducing the risk for blood-borne virus transfer in a model of simulated glove perforation.

Non-aqueous emulsions stabilized by block copolymers: application to liquid disinfectant-filled elastomeric films.

The emulsifying and stabilization efficiency of polybutadiene-b-poly(ethylene oxide) and poly(ter butylstyrene)-poly(ethylene oxide) diblock copolymers is examined in non-aqueous emulsions. These emulsions are formed by a dispersion of polyethylene glycol mixed with a cationic surfactant acting as a biocide, in a continuous phase of a thermoplastic elastomer (SEBS) dissolved in methylcyclohexane. Emulsions with controlled droplet size and excellent stability could be obtained, which by solvent evaporation lead to elastomeric films containing droplets of confined disinfecting liquids.

Biocide squirting from an elastomeric tri-layer film.

Protective layers typically act in a passive way by simply separating two sides. Protection is only efficient as long as the layers are intact. If a high level of protection has to be achieved by thin layers, complementary measures need to be in place to ensure safety, even after breakage of the layer-an important issue in medical applications. Here, we present a novel approach for integrating a biocide liquid into a protective film (about 300-500 microm thick), which guarantees that a sufficient amount of biocide is rapidly released when the film is punctured. The film is composed of a middle layer, containing the liquid in droplet-like compartments, sandwiched between two elastomeric boundary layers. When the film is punctured, the liquid squirts out of the middle layer. A theoretical model was used to determine the size and density of droplets that are necessary to ensure a sufficient quantity of biocide is expelled from an adequately elastic matrix to provide protection at the site of damage. We demonstrate the utility of this approach for the fabrication of surgical gloves.

Virus-inhibiting surgical glove to reduce the risk of infection by enveloped viruses.

Needle puncture and other accidents that occur during surgery and other procedures may lead to viral infections of medical personnel, notably by hepatitis C (HCV) and human immunodeficiency virus (HIV), now that hepatitis B can be prevented by vaccination. A new surgical glove called G-VIR, which contains a disinfecting agent for enveloped viruses, has been developed. Herpes simplex type 1 (HSV) was used as a standard enveloped virus in both in vitro and in vivo tests of the virucidal capacity of the glove. Bovine viral diarrhea virus (BVDV) and feline immunodeficiency virus (FIV) were used as models for HCV and HIV, respectively. For in vitro study, a contaminated needle was passed through a glove and residual virus was titrated; for in vivo studies, animals were stuck with a contaminated needle through a glove. Despite variation in virus enumeration inherent in the puncture technique, statistical evaluation showed that infection was reproducibly and substantially reduced by passage through the virucidal layer. For BVDV, the amount of virus passing through the virucidal glove was reduced in 82% of pairwise comparisons with control gloves that lacked the virucidal agent; when plaque counts were adjusted to a common dilution, the median count for the virucidal glove was on the average reduced >10-fold. In experiments in which the proportion of wells infected with FIV was measured, the ratio of TCID(50) values (control glove to G-VIR) was >15, and probably much higher. For HSV, the amount of virus passing through the virucidal glove was reduced in 81% of comparisons with control gloves; the median of adjusted plaque counts was reduced on the average approximately eightfold or ninefold. In vivo tests with FIV and HSV in cats and mice, respectively, found smaller percentage reductions in infection than the in vitro tests but confirmed the virucidal effect of the gloves.