Tribological properties of MAO ceramic coatings with annulus array texture on disposable surgical gloves.

Introduction: In recent research, the expansion in the use of Mg alloys for biomedical applications has been approached by modifying their surfaces in conjunction with micro-arc oxidation (MAO) techniques which enhance their abrasion and corrosion resistance. Methods: In this study, combining laser texturing and MAO techniques to produce the dense ceramic coatings with microstructures. On the surface of the AZ31 Mg alloy, a micro-raised annulus array texture has been designed in order to increase the surface friction under liquid lubrication and to improve the operator's grip when holding the tool. For this work, the micro-morphology of the coatings was characterised, and the friction properties of the commonly used scalpel shank material 316 L, the untextured surface and the textured surface were comparatively analysed against disposable surgical gloves. Results and discussion: The results show that the Laser-MAO ceramic coating grows homogenous, the porosity decreases from 14.3% to 7.8%, and the morphology after friction indicates that the coating has good wear resistance. More specifically, the average coefficient of friction (COF) of the three types of gloves coated with Laser-MAO ceramic was higher than that of the 316 L and MAO ceramic coatings under the action of the annulus-integrated texture under the lubrication conditions of physiological saline and defatted sheep blood, which achieved the goal of increasing friction for the purpose of helping to prevent the problem of tool slippage from the hand.

Development of a Mass Spectrometry Imaging Method to Evaluate the Penetration of Moisturizing Components Coated on Surgical Gloves into Artificial Membranes.

Skin dryness and irritant contact dermatitis induced by the prolonged use of surgical gloves are issues faced by physicians. To address these concerns, manufacturers have introduced surgical gloves that incorporate a moisturizing component on their inner surface, resulting in documented results showing a reduction in hand dermatitis. However, the spatial distribution of moisturizers applied to surgical gloves within the integument remains unclear. Using matrix-assisted laser desorption/ionization (MALDI)-mass spectrometry imaging (MSI), we investigated the spatial distribution of moisturizers in surgical gloves within artificial membranes. Recently, dermal permeation assessments using three-dimensional models, silicone membranes, and Strat-M have gained attention as alternative approaches to animal testing. Therefore, in this study, we established an in vitro dermal permeation assessment of commercially available moisturizers in surgical gloves using artificial membranes. In this study, we offer a methodology to visualize the infiltration of moisturizers applied to surgical gloves into an artificial membrane using MALDI-MSI, while evaluating commercially available moisturizer-coated surgical gloves. Using our penetration evaluation method, we confirmed the infiltration of the moisturizers into the polyethersulfone 2 and polyolefin layers, which correspond to the epidermis and dermis of the skin, after the use of surgical gloves. The MSI-based method presented herein demonstrated the efficacy of evaluating the permeation of samples containing active ingredients.

Hand Scrubbing and Donning of Sterile Surgical Gloves: An Observational Clinical Audit of Novice Dental Surgeons.

Background The most critical factors in the satisfactory recovery of a patient post-surgery are obedience to sterilization and aseptic protocol. Using aseptic principles, the standard hand scrubbing and gloving procedure prevents contamination of the surgical site and aids in infection control.  Methods Eighty dental interns were observed during minor oral surgical procedures for hand scrubbing and donning sterile surgical gloves, following the steps and guidelines provided by World Health Organization (WHO). The dental interns were evaluated, and in order to enhance their understanding of hand scrubbing and donning surgical gloves, desensitization programs were conducted through lectures using PowerPoint presentations. After one week, the participants were observed and evaluated again. This program made the participants aware of asepsis and infection control in clinical practice. Results Prior to intervention, only 37.14% of young dental surgeons performed proper conventional hand hygiene practices. After the intervention, this percentage increased to 62.142%, indicating a significant improvement. Regarding the donning of sterile surgical gloves, 43.75% of participants followed the standard steps before the intervention. After the intervention, the percentage raised to 86.25% indicating substantial growth. Conclusion Observations before and after the evaluation demonstrated significant changes in the acceptance rates for the fundamental criteria of hand hygiene and donning sterile surgical gloves. Adhering to both procedures according to WHO guidelines will help to reduce the risk of infections and raise awareness about asepsis in the practice among young dental surgeons.

Effect of sterile vs clean gloves for cervical checks in labor on maternal infection at term: a randomized trial.

BACKGROUND: Intrapartum infection usually warrants immediate delivery and impacts 5-12% of term pregnancies, with the most commonly identified pathogenic organism being of the Ureaplasma genus. When performing cervical examinations during labor, providers in the United States commonly use sterile gloves, although there are no data currently to support that this practice reduces rates of infection. Furthermore, in nearly all other settings of Gynecologic care, aside from surgery in an operating room, nonsterile gloves are used. Even though the uterus could be sterile in normal pregnancies, the provider performing the cervical examination must traverse the milieu of vaginal bacteria in order to reach the cervix to perform the exam, introducing vaginal microbiota into the uterus regardless of the type of glove used. This prospective randomized controlled study examines whether the type of glove used (sterile vs clean) impacts the rates of intrapartum infection in patients receiving cervical examinations during labor or induction of labor at term.. OBJECTIVE: This study aimed to evaluate if the glove type (sterile vs clean) used for cervical examinations during labor affects the rates of intrapartum and postpartum infection. STUDY DESIGN: This randomized controlled trial assigned eligible and consenting participants to receive cervical examinations during labor with either sterile powder-free polyvinyl chloride examination gloves (current routine practice, control group) or clean powder-free nitrile examination gloves (nonsterile, experimental group). The primary outcome was rates of intrapartum infection (chorioamnionitis). Sample size calculations estimated that 300 participants would be needed with a rate of infection of 10% in the control group and 20% in the experimental group to demonstrate difference between the groups; however, the rates of infection were much lower than expected, at 5.4% and 4.4% in the sterile and clean glove group, respectively. At this point, it was determined futile to continue the study because a sample size of >29,000 participants would be needed, which would not be achievable at a single tertiary care referral center with approximately 3500 deliveries per year. The study was approved by the Eastern Virginia Medical School Institutional Review Board (IRB 21-09-FB-0206), and was registered at ClinicalTrials.gov (identifier NCT05603624; https://clinicaltrials.gov/ct2/show/NCT05603624). RESULTS: A total of 163 participants with singleton pregnancies completed the study; 74 (45%) were randomized to the sterile glove group, and 89 (55%) were randomized to the clean glove group. In the sterile glove group, 4 (5.4%) developed intrapartum infection (chorioamnionitis) and 1 (1.3%) developed postpartum infection (endometritis). In the clean glove group, 4 (4.4%) developed intrapartum infection and 2 (2.2%) developed postpartum infection. There was no significant difference in rates of intrapartum infection (P=1.0) or postpartum infection (P=1.0), or combined rates of infection (including both chorioamnionitis and endometritis; P=.99) between the sterile and the clean glove group. When comparing the participants from both groups who had any intrapartum or postpartum infection (n=11) with those who had no infection (n=152), the former were more likely to be nulliparous (P=.01), have lower gravidity (P<.01) and parity (P<.01), have longer times from first cervical examination to delivery (P=.02), have longer times from rupture of membranes to delivery (P=.0001), undergo cesarean delivery (P=.0002), and experience postpartum hemorrhage (P=.001). Although participants who were in labor for a longer time also likely had more cervical examinations, these data could suggest that duration of labor (P=.02) is more closely associated with infectious morbidity compared with the number of cervical examinations (P=.15). CONCLUSION: Using clean gloves for cervical examinations during labor is unlikely to increase risk of infection, and could reduce cost by up to 92.4% at our institution, saving over $25,000 annually.

Frugal indigenous vessel loop made from a surgical glove.

We report a simple cost effective alternative to commercially available vessel loops made from sterilized surgical gloves for retraction of vital structures during vascular trauma, micro-vascular, micro-neural surgery.

Cambio rutinario de instrumental y guantes quirúrgicos en cirugía abdominal: ¿cuál es el impacto sobre el riesgo de infección? / Routine change of surgical instruments and gloves in abdominal surgery: what is the impact on the risk of infection?

Objetivo: Analizar la evidencia más actualizada sobre el cambio rutinario de instrumental y guantes quirúrgicos en cirugía abdominal, y su impacto en el riesgo de infecciones. Métodos: Se realizó una búsqueda bibliográfica, en las bases de datos PubMed, ScienceDirect, Web of Science, y MEDLINE. Resultados: A la fecha, la evidencia sumamente escasa sobre el potencial impacto del cambio rutinario de instrumental y guantes quirúrgicos en cirugía abdominal, y su relación con la incidencia de infección en el sitio operatorio. Sin embargo, no deja de ser un tema de interés en cirugía global. El estudio ChEETAh, ensayo realizado en siete países de bajos y medianos ingresos, que evaluó el cambio rutinario tanto de guantes como de instrumental quirúrgico en cirugía abdominal y su relación con la infección, demostró que, la frecuencia de infección en sitio operatorio fue del 16% (n=931) en el grupo intervención, comparado a un 18,9% (n=1280) en el grupo control (RR 0,87; IC 95%: 0,79 ­ 0,95; p=0,0032). Así, podría existir cierta protección adicional con el cambio rutinario de guantes e instrumental en cirugía abdominal. Conclusión: Aunque la evidencia es limitada y heterogénea, existe una tendencia respecto a un potencial beneficio frente a la incidencia de infección en sitio operatorio, en el cambio rutinario de guantes e instrumental quirúrgico en cirugía abdominal(AU)

Objective: To analyze the most recent evidence regarding the routine change of surgical instruments and gloves in abdominal surgery and its impact on the risk of infections. Methods: A literature search was conducted in the PubMed, ScienceDirect, Web of Science, and MEDLINE databases. Results: To date, the evidence regarding the potential impact of routine changes in surgical instruments and gloves in abdominal surgery and their relationship with the incidence of surgical site infections is extremely scarce. Nevertheless, it remains a topic of interest in global surgery. The ChEETAh study, conducted in seven low and middle-income countries, which assessed the routine change of both gloves and surgical instruments in abdominal surgery and its relation to infection, demonstrated that the frequency of surgical site infection was 16% (n=931) in the intervention group compared to 18.9% (n=1280) in the control group (RR 0.87; 95% CI: 0.79 ­ 0.95; p=0.0032). Thus, there may be some additional protection with the routine change of gloves and instruments in abdominal surgery. Conclusion: Although the evidence is limited and heterogeneous, there is a trend suggesting a potential benefit in reducing the incidence of surgical site infections through the routine change of gloves and surgical instruments in abdominal surgery(AU)

The strange history of surgical gloves in orthopaedic surgery (part I): from no gloves and no hand washing to the introduction of cotton gloves in orthopaedic surgery.

PURPOSE: The goal was to evaluate the advent of surgical gloves during the eighteenth century, nineteenth century, and the beginning of the twentieth century. MATERIAL AND METHODS: We used first drawings and paintings, then historical photographs identified in books after 1830 (date of discovery of the photography) or in medical reports of surgery and anesthesiologists. The pictures determined the presence or absence of gloves in the period corresponding to the changing understanding of aseptic and antiseptic techniques proposed by Lister and Pasteur. RESULTS: There was an evolution of the material of gloves, but surgeons throughout time remained significantly opposed to gloves for a long period. Concerning materials, the caecum of a sheep, cotton, silk, leather, and crude rubber were used before the introduction of latex by Goodyear. For surgeons, gloves were introduced initially to protect theatre staff's and surgeon hands from infection and not to protect the patient. Many surgeons contributed to the evolution of surgical gloves, and the use of gloves was an evolutionary process rather than a discovery. The probability that a surgeon had gloves on photographs was 0% in 1860-1870 (period of Lister and Pasteur), 5% in 1890, 28% in 1900, 42% in 1910, 48% in 1920, 58% in 1930, and 75% during the World Word II and reached 100% only in 1950. CONCLUSION: While some reports suggest that by 1920, the use of gloves in surgery became routine practice, in reality, around 30% of trauma surgeons were not wearing gloves until 1939.

Wearable Natural Rubber Latex Gloves with Curcumin for Torn Glove Detection in Clinical Settings.

Glove tear or perforation is a common occurrence during various activities that require gloves to be worn, posing a significant risk to the wearer and possibly others. This is vitally important in a clinical environment and particularly during surgical procedures. When a glove perforation occurs (and is noticed), the glove must be replaced as soon as possible; however, it is not always noticeable. The present article is focused on the design and development of a novel fluorescence-based sensing mechanism, which is integrated within the glove topology, to help alert the wearer of a perforation in situ. We hypothesized that natural rubber gloves with curcumin infused would yield fluorescence when the glove is damaged, particularly when torn or punctured. The glove design is based on double-dipping between Natural Rubber Latex (NRL) and an inner layer of latex mixed with curcumin, which results in a notable bright yellow-green emission when exposed to UV light. Curcumin (Cur) is a phenolic chemical found primarily in turmeric that fluoresces yellowish-green at 525 nm. The tear region on the glove will glow, indicating the presence of a Cur coating/dipping layer beneath. NRL film is modified by dipping it in a Cur dispersion solution mixed with NRL for the second dipping layer. Using Cur as a filler in NRL also has the distinct advantage of allowing the glove to be made stronger by evenly distributing it throughout the rubber phase. Herein, the optimized design is fully characterized, including physicochemical (fluorescence emission) and mechanical (tensile and tear tests) properties, highlighting the clear potential of this novel and low-cost approach for in situ torn glove detection.

Comparison of Unnoticed Glove Perforations during Minimally Invasive versus Open Surgeries: A Systematic Review and Meta-Analysis.

OBJECTIVE: Various studies have depicted the incidence of glove perforations during open (OS) and minimally invasive surgeries (MIS). The aim of this meta-analysis was to compare the incidence of macroscopic and microscopic glove perforations during MIS and OS. METHODS: The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Scientific databases (PubMed, Web of Science, Scopus, and EMBASE) were systematically searched for comparative studies depicting the glove perforation rates during MIS and OS. Risk ratios (RR) were calculated for both the outcomes (dichotomous) and the Mantel-Haenszel method was utilized for the estimation of pooled RR. The methodological quality assessment was performed by two independent investigators using the Downs and Black scale. The main outcomes of the study were the proportion of gloves with gross (macroscopic) perforations and the proportion of gloves with microscopic perforations. RESULTS: Four comparative studies including a total of 1428 gloves (435 from the MIS group) were included. Pooling the data demonstrated no difference in the incidence of macroscopic glove perforations among the MIS and OS groups (RR 0.57, 95% CI 0.21 to 1.54, p = 0.27). On the other hand, the incidence of microscopic perforations was significantly higher in the OS group versus the MIS group (RR 0.72, 95% CI 0.55 to 0.95, p = 0.02). However, all the studies had a moderate risk of bias. CONCLUSIONS: When compared to OS, the macroscopic glove perforation rate during MIS showed no significant difference. The incidence of microscopic glove perforations was significantly higher during OS as compared to MIS. However, due to the moderate risk of bias of the available comparative studies, the level of evidence of these studies is limited.

Comparison of surgical gloves: perforation, satisfaction and manual dexterity.

The purpose of this study was to assess the effectiveness of two different surgical gloves (powdered latex and powder and latex free) for glove perforation frequency, problems and satisfaction with glove usage and manual dexterity levels during surgical operations that include scrub nurses. Scrub nurses wore antiallergenic gloves (powder and latex free) gloves during three operations, double latex and powdered gloves during three operations and single latex and powdered gloves during three operations. The gloves were checked for punctures after each surgery with a water-inflation test. In our study, 19% of single gloves and 18.1 % of double gloves and 4.8% of powder and latex free worn by scrub nurses were punctured during surgery. None of the inner gloves in double gloves were punctured. Although wearing double gloves restricts manual dexterity, results in discomfort problems such as perspiration and fetor and results in a low satisfaction rate among scrub nurses, double gloves are protective against injuries and punctures.

An intraoperative assessment of bacterial contamination on surgical helmets and gloves during arthroplasty surgeries.

INTRODUCTION: Infection is a devasting complication after primary and revision arthroplasty. Therefore, identifying potential sources of infection can help to reduce infection rates. The aim of this study was to identify the impact and potential risk of contamination for glows and surgical helmets during arthroplasty procedures. METHODS: Surveillance cultures were used to detect contamination of the glow interface during the surgery and the surgical helmets immediately at the end of the surgery. The cultures were taken from 49 arthroplasty procedures from the surgeon as well as the assisting surgeon. RESULTS: In total, 196 cultures were taken. 31 (15.8%) of them showed a contamination. 12 (13.5%) of 98 cultures taken from the surgical helmets were positive, while 18 (18.3%) of 96 cultures taken from the gloves showed a contamination. DISCUSSION: The study showed that during arthroplasty procedures, surgical helmets and gloves were frequently contaminated with bacteria. In 20 of 49 (40.8%) arthroplasty surgeries, either the surgical helmet or the gloves showed a contamination. Surgeons should be aware that they might be a source for infection during arthroplasty surgeries.

Application of COVID-19 single-use shredded nitrile gloves in structural concrete: Case study from Australia.

The use of single-use nitrile gloves has been on a sharp incline since the Coronavirus pandemic first started in late 2019. This led to a significant increase in the generation of this clinical waste that requires various recycling solutions to reduce its environmental impact from disposal or incineration. This paper explores its application in structural concrete by adding shredded nitrile gloves at 0.1%, 0.2%, and 0.3% of the volume of concrete. The compressive strength, modulus of elasticity, ultrasonic pulse velocity, and SEM-EDS analysis were undertaken to ascertain the effect of different concentrations of shredded nitrile gloves on the mechanical properties, quality of concrete, and its bond performance with the cement matrix. The results demonstrate that the inclusion of up to 0.2% of shredded nitrile gloves can provide ~22% improvement in the compressive strength of blended concrete composites at 28-days of curing. In comparison, the inclusion of 0.3% of shredded nitrile gloves shows improvements of ~20% in compressive strength at 28-days. The SEM-EDS analysis shows a very good bond formation between the nitrile rubber and the cement matrix with no gap identified in the interfacial transition zone (ITZ).

Surgical experience and different glove wearing conditions affect tactile sensibility.

Background: The fingers' tactile sensibility is essential in surgery, especially in microsurgery. Therefore, surgeons seeking to improve their performance often prefer certain glove brands and wearing habits. There is the need of objectively testing these glove wearing conditions and determine the effect of surgical experience with regard to tactile sensibility by comparing surgeons with non-surgeons. Methods: This cross-sectional single-center pilot-study was conducted between June and August 2021. Two groups of 27 surgeons and 27 non-surgeons underwent two-point-discrimination (2PD) and Semmes-Weinstein monofilament testing (SWMT) of both index fingers with bare hands and with wearing six different brands of surgical gloves. Different wearing conditions, such as single-gloving, double-gloving, well-fitted, under- and oversized gloves, were evaluated within and between the groups. Results: Most glove types decreased tactile sensibility (2PD and SWMT) of surgeons and non-surgeons. Interestingly, the thinnest gloves showed similar 2PD values to bare hands in both groups. Double-gloving negatively impacted SWMT, without influencing 2PD. Undersized gloves showed better 2PD and SWMT than well-fitted gloves, while oversized gloves showed no tactile drawbacks. With bare hands and certain glove conditions, the surgeons' 2PD and SWMT was significantly better than the non-surgeons', indicating a positive effect of surgical experience on tactile sensibility. Conclusion: Our study demonstrated the positive impact of surgical experience on tactile sensibility, as demonstrated by the surgeons. The sensibility of the gloved hand varies on the surgical glove type, but favors thinner gloves, single gloving (rather than double gloving) and undersized or well-fitted gloves.

Non-sterile examination gloves and sterile surgical gloves: which are more sustainable?

BACKGROUND: Healthcare professionals should consider environmental sustainability when using personal protective equipment (PPE). One of the most frequently used items of PPE in medical settings are gloves. AIM: This study aims to quantify the environmental impact of sterile versus non-sterile gloves using the life cycle assessment (LCA) methodology. METHODS: This study used three glove types: non-sterile gloves and sterile gloves (latex and latex-free). Sixteen different environmental impact categories were used to demonstrate the impact of each glove type. FINDINGS: Non-sterile gloves had the least environmental impact in all categories. The two types of sterile gloves, non-latex (synthetic rubber) and latex (natural rubber), performed similarly, although the non-latex gloves had a greater impact on ozone depletion, mineral use and ionizing radiation. For climate change impact, sterile latex gloves were 11.6 times higher than non-sterile gloves. This study found that for both sterile type gloves (latex and non-latex), the manufacture of the gloves contributes to the most considerable environmental impact, with an average of 64.37% for sterile latex gloves and 60.48% for non-latex sterile gloves. CONCLUSION: Using the LCA methodology, this study quantitatively demonstrated the environmental impact of sterile versus non-sterile gloves.

Compliance with hygiene practices among healthcare workers at an academic hospital emergency department.

INTRODUCTION: Healthcare-associated infections (HCAIs) are an important contributor to patient morbidity and mortality. Healthcare workers (HCWs) hands are the chief mode of transmission of HCAIs. The emergency centre (EC) is frequently the first point of contact for patients within the health care system. The aim of this study is to determine compliance with hygiene practices among healthcare workers at a tertiary hospital EC. METHODS: Hygiene practices of staff were observed over a six-week period. Data pertaining to compliance rates with hand cleansing and other hygiene practices was collected. Consent was obtained retrospectively to avoid influencing participant behaviour. RESULTS: From a total of 477 potential hygiene opportunities, compliance with hand hygiene was only 34.4% (n = 164). Hand cleansing with an alcohol-based hand rub was observed in 87 (26.7%) of the 326 (68.3%) opportunities where it was indicated, while handwashing with soap and water was observed in 35 (23.2%) of the 151 opportunities where this was indicated. Compliance to each of the six steps of handwashing ranged between 62.2% and 83.5%, with there being a gradual deterioration in compliance from step one through to step six. Compliance with 'bare below the elbows' was observed in 242 (50.7%) opportunities while disposable surgical gloves were worn on 85 (44.7%) of the 190 opportunities where this was indicated. CONCLUSION: Compliance with hygiene practices among EC HCWs is suboptimal. Various strategies including ongoing systematic training and regular audits may improve overall hygiene practices among EC staff.

Using the MEAT VBP Framework to analyse and understand the value of surgical gloves: an explanatory case study.

BACKGROUND: Value-based healthcare is being extensively piloted, scaled and implemented by healthcare providers and systems around the world. However, the ability of the healthcare supply chain function to strategically contribute to the improvement of value has been held back by a lack of practical tools for turning value-based procurement from concept into action. Two recently developed conceptual models - the American CQO Movement and the European MEAT VBP Framework - have been developed to support the implementation of value-based procurement in healthcare. We demonstrate how the latter of these models can be adapted and applied pragmatically to generate insights into the value of a specific medical device, technology or consumable. METHODS: We undertook an explanatory, qualitative, single-case study focused on a specific consumable - surgical gloves - that provide a critical example of a type of medical device usually procured in high volumes but at risk of commoditisation due to a widespread lack of understanding of their value. Since the global Covid-19 pandemic prevented fieldwork, structured interviews were conducted via Zoom and corroborated by a literature review. RESULTS: We identified ten cost criteria and eight outcome criteria with which the value of surgical gloves can be analysed and understood. For each of these criteria we propose definitions and value impact metrics that decision-makers can use during a procurement exercise to describe, quantify and compare glove value. CONCLUSION: The MEAT VBP Framework provides a highly practical and adaptable means of imposing both structure and rigour on a value analysis process and of qualitatively describing the potential value impact of surgical gloves for patients, professionals, providers and health systems.

Glove and instrument changing to prevent bacterial contamination in infected wound debridement and closure procedures: A prospective observational study.

Many surgeons use a single table of instruments for both excisional debridement and coverage/closure of infected wounds. This study investigates the effectiveness of a two-table set-up of sterile instruments, in addition to glove exchange, to reduce instrument cross-contamination during these procedures. This is a prospective, single-site, institutional review board-approved observational study of surgical debridements of infected wounds over a 17-month period. Two separate sterile surgical tables were used for each case: Table A for initial wound debridement (debridement set-up) and Table B for wound coverage/closure (clean set-up). Swabs of each table and its respective instruments were taken after debridement but prior to coverage/closure. The primary outcome of interest was bacterial growth at 48 hours. There were 72 surgical cases included in this study. Culture results of Table A demonstrated bacterial growth in 23 of 72 (32%) cases at 48 hours compared with 5of 72 (7%) from Table B (P = .001). These data suggest that there is significant bacterial contamination of surgical instruments used for debridement of infected wounds. Use of a two-table set-up reduced instrument cross-contamination by 78%, suggesting avoidable re-contamination of the wound.

Compression therapy using surgical gloves does not prevent paclitaxel-induced peripheral neuropathy: results from a double-blind phase 2 trial.

BACKGROUND: Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect of paclitaxel (PTX). There is no known prophylactic measure, although there are some reports of prevention with compression therapy using surgical gloves. On account of its predominantly subjective symptoms, it is difficult to exclude bias when assessing for CIPN. In this study, we assessed the effectiveness of the same procedure for the prevention of paclitaxel-induced PN based on a double-blind study design. METHODS: The patients with early and recurrent breast cancer (with no prior PTX exposure) initiating weekly chemotherapy with PTX 80 mg/m2 were enrolled. Each patient donned two gloves on each hand at every PTX infusion. Two one-size-smaller gloves were donned on one hand (study side) and two normal-size gloves were donned on the other hand (control side) during 90 min from 30 min before the infusion to 30 min after the end of the infusion. Study side are blind for both patients and assessing physicians according to determination of the study side by research nurses in the chemotherapy unit. The primary outcome was the difference in the frequency of CIPN (motor/sensory) determined by the physician using the common terminology criteria for adverse events (CTCAE v4.0), with an evaluation at each cycle of PTX infusion. McNemar test was used to assess the primary outcome. RESULTS: Between July 2017 and November 2018, 56 patients were enrolled and 49 patients were evaluated. Overall, Grade ≥ 2 PN (sensory) was observed in 30.6 and 36.7% in the study and control sides, respectively (McNemar p = 0.25). PN (motor) was observed in 4.1 and 6.1% in the study and control sides, respectively (McNemar p = 1.0). CONCLUSION: Surgical glove compression therapy showed no statistically significant effect on the incidence of PTX-induced PN. TRIAL REGISTRATIONS: This study was registered with the University Hospital Medical Information Network (UMIN) Clinical Trials Registry managed by the National University Hospital Council of Japan ( UMIN000027944 ). Registered 26 June 2017.

Effectiveness of double-gloving method on prevention of surgical glove perforations and blood contamination: A systematic review and meta-analysis.

AIMS: To determine the effectiveness of the double-gloving method on preventing surgical glove perforation and blood contamination compared with single gloving. DESIGN: Systematic review. DATA SOURCES: Seven electronic databases were searched including: Embase, CINAHL, OVID, Medline, Pubmed, Web of Science, and Foreign Medical Literature Retrieval Service in March 2020. REVIEW METHOD: Our systematic review and meta-analysis was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) reporting guideline. Risk of bias of Cochrane Handbook (Version 5.1.0) was applied to evaluate the study quality. Revman 5.3 was used to calculate the effect size of odds ratio (OR) with 95% confidence interval (CI). Meta-analysis with forest plot and funnel plot was performed to compare the rate of surgical glove perforation and to determine the published bias, respectively. This review has been registered with ID: CRD42020189694 on the web site of PROSPERO. RESULTS: Seven randomized controlled trials regarding the efficacy of double gloving on reducing surgical glove perforation were identified and a total of 7090 gloves were tested. After analyzing the pooled data, we identified that the rate of surgical glove perforation in the double-gloving group was lower than that of single gloving with statistical significance (OR = 0.75, 95% CI: 0.64-0.89, p < .05). It was statistically significant that surgical glove perforation was lower in the double-inner gloves as well as matched outer-inner perforated gloves compared with that of single glove (OR = 0.05, 95% CI: 0.03-0.07, p < .05). CONCLUSION: Findings of this systematic review demonstrate that double gloving could reduce the rate of surgical-glove perforation. Meanwhile, the risk of being contaminated by a blood-borne pathogen during surgery could be reduced by wearing double gloves. We strongly suggest that surgical team members when operating should wear double gloves to protect themselves and reduce the risk of occupational blood exposure. IMPACT: The necessity of double gloving for preventing blood contamination was demonstrated. The rate of surgical glove perforation is statistically significant in double-gloving group compared to single gloving. Double gloving could reduce the risk of being contaminated during surgery by blood-borne pathogen. Evidence is provided for surgical team and decision makers that double gloving could reduce occupational exposure.