Disinfection of gloved hands during the COVID-19 pandemic.

BACKGROUND: Disinfection of gloves can be used during a pandemic situation when performing various procedures on the same patient or when removing personal protective equipment. If performing glove disinfection, there is a need to check the compatibility of gloves with the disinfectant product used. AIM: To test the resistance of nitrile gloves to various disinfectant solutions. METHODS: One hundred percent powder-free nitrile gloves, composed of nitrile butadiene rubber compounds, were exposed to various disinfectants to analyse resistance. The seven most commonly used disinfectant solutions in the healthcare field were selected for testing. The effects of each disinfectant were analysed in comparison with the control group (untreated glove). For tensile testing, the thickness of each test specimen was measured with a micrometer. FINDINGS: Bleach solution decreased the breaking load of gloves, although to a lesser extent than disinfectants that contained ethanol. CONCLUSION: Disinfectants that contain alcohol decrease the breaking load of nitrile gloves.

Transmission of human papillomavirus DNA from patient to surgical masks, gloves and oral mucosa of medical personnel during treatment of laryngeal papillomas and genital warts.

The risk of occupational human papillomavirus (HPV) transmission from patient to medical personnel during laser vaporization procedures remains controversial. The purpose of this study was to determine the risk of HPV transmission from the patient to the protective surgical masks, gloves and oral mucosa of medical personnel during the treatment of laryngeal papillomas and genital warts. The study involved five male patients scheduled for the surgical treatment of laryngeal papillomas, and five male patients undergoing carbon dioxide (CO(2)) laser treatment for urethral warts. Oral mucosa specimens were obtained from the study patients and the employees pre- and postoperatively. Samples were collected from the HPV-infected patient tissue, and from the surgical masks and gloves used by the employees. A total of 120 samples were analyzed for the presence of HPV DNA by PCR, using the degenerated MY09/11/HMB01 primers. After the papilloma procedures, the surgeons' gloves tested HPV positive in one of the five cases and those of the surgical nurse in three of the five cases. After the treatment of genital warts, HPV DNA corresponding to the patient tissue specimens was present in all the samples obtained from the surgical gloves of the operators. All oral mucosa samples obtained from 18 different employees tested HPV negative, as did the surgical mask specimens. According to our study, HPV may contaminate protective equipment, most of all surgical gloves, but transmission of HPV DNA to medical personnel is unlikely to occur provided that protective surgical gloves and masks are applied and disposed of properly.

The ostrich syndrome: obstetrician gynecologists and human immunodeficiency virus exposure.

Obstetrician-gynecologists and midwives as well as surgical and labor and delivery staff are at risk for contact with human immunodeficiency virus (HIV), but measures can be taken to reduce the risk of exposure and transmission. Physician denial of exposure is common. Prompt identification of exposure, including rapid testing of index patients of unknown HIV status, combined with prompt initiation of prophylactic medication, may reduce transmission by 81%.

First clinical study of a new virus-inhibiting surgical glove.

QUESTION UNDER STUDY: Prospective clinical study to evaluate the tolerance, ergonomics and glove barrier value (mechanical resistance to breach) of a new surgical glove sandwiching droplets of a disinfecting agent between two layers of a synthetic elastomer (G-VIR) able to inactivate viruses when breached. METHODS: 100 surgical procedures were performed by six surgeons wearing G-VIR on 100 patients included after informed consent. Procedures were classified into laparoscopic (n = 28) or open surgery (n = 72); open surgery being subdivided either into superficial (n = 33) and deep (n = 39) or into hernia (n = 32) and non hernia (n = 40). The ergonomics and tolerance of the glove were evaluated by the surgeons using a questionnaire. Patients were clinically evaluated daily during hospitalization and once between the 4th to 6th postoperative week. All used gloves underwent a water leak test to detect any breach. RESULTS: 834 G-VIR gloves were used, 456 by the first surgeon and 378 by the assistant surgeon, resulting in 195 exposures, lasting 288 operator-hours (OH). No adverse effect on patients and/or surgeons linked to G-VIR could be observed. Ergonomics of G-VIR has been evaluated as equivalent as standard double gloving, excepted for donning which was more difficult (P <0.05). The breach rate per glove (BRpG) amounted to 1.8%. According to breach rate per operator-hour (BRpOH), surgical procedures could be categorized in low (laparoscopy), middle (non hernia and hernia superficial) and high (hernia deep) risk procedures. CONCLUSIONS: G-VIR gloving offers an excellent mechanical protection, is suitable for daily surgical practice and maybe recommended in high risk surgical procedures.

Standardization of needlestick injury and evaluation of a novel virus-inhibiting protective glove.

Rubber surgical gloves worn as a barrier to prevent contamination from body fluids offer relative protection against contamination through direct percutaneous injuries involving needles, scalpel blades or bone fragments. To determine the main experimental parameters influencing the volume of blood transmitted by a hollow-bore needle (worst case scenario) during an accidental puncture, we designed an automatic puncture apparatus. Herpes simplex type 1 virus (HSV1), a model for enveloped viruses, was used as a 'marker' in an in-vitro gelatine model. Of the experimental parameters studied, the most critical influences were found to be needle diameter and puncture depth, whereas puncture speed, puncture angle and glove-stretching feature appeared to be less influential. A single glove reduced the volume of blood transferred by 52% compared with no glove, but double gloving offered no additional protection against hollow-bore needle punctures. Using 'standardized' puncture conditions, the virus-inhibiting surgical glove G-VIR elicited an 81% reduction in the amount of HSV1 transmitted as compared with single or double latex glove systems.

Testing for viral penetration of non-latex surgical and examination gloves: a comparison of three methods.

Currently, there are no international standards based on microbiological methodology for testing the ability of medical examination or surgical gloves to prevent the passage of viruses. Three protocols for the direct examination of the viral barrier properties of non-latex gloves were compared with 1080 gloves (270 gloves from each of two surgical brands and two medical examination brands). In two of the methods, gloves were filled with and suspended in a nutrient broth solution, and bacteriophage phiX174 was placed either inside or outside the glove, while the entire test vessel was agitated. Gloves tested using the third method were filled with a suspension of bacteriophage and allowed to rest in a vessel containing nutrient broth. Gloves were tested directly from the manufacturer's packaging, or after being punctured intentionally or subjected to a stress protocol. The passage of bacteriophage was detected with plaque assays. Significant differences in failure rates between glove brands were apparent only among gloves that had been subjected to the stress protocol. Overall, the two methods in which bacteriophage were placed inside the gloves provided more sensitivity than the method in which bacteriophage was spiked into broth outside the gloves. Thus the placement of bacteriophage inside test gloves (or the use of pressure across the glove barrier during testing), and the use of a standardised stress protocol, will improve significantly the ability of a glove test protocol to determine the relative quality of the barrier offered by medical examination and surgical gloves. Further research is needed to provide test methods that can incorporate reproducibly both the use of bacteriophage and simulated glove use in an industrial quality control setting.

A whole-glove method for the evaluation of surgical gloves as barriers to viruses.

BACKGROUND: Today, because of the wide variety of infectious agents encountered in the health care environment, clinicians must be particularly concerned about the potential for small-sized virus penetration through glove defects. OBJECTIVE: To describe a method for testing gloves that evaluates the entire glove and allows for detection of low levels of virus penetration. Ten sets of 10 different gloves from 4 manufacturers were evaluated using this method. METHODS: Barrier properties were evaluated using the bacteriophage, phiX174. Gloves were filled with surfactant solution placed in flasks containing 10(6) viruses per mL. Flasks were agitated at 37 degrees C +/- 2 degrees C and assayed for 180 minutes. RESULTS: Virus penetration was detected in 8% of the 100 gloves tested using the quantitative assay. The qualitative assay determined that 14% of the gloves tested allowed penetration.