Perfurações não detectadas de luvas em procedimentos de urgência

Silvia Cristine Soldá,Jacqueline Arantes G Perlingeiro,Jose Gustavo Parreira,Thiago Da Silveira Manzione,Marcelo P Cury,Paulo De Azeredo Passos Candelária,José Cesar Assef

doi:10.1590/s0104-42302009000500026

Silvia Cristine Soldá, Jacqueline Arantes G Perlingeiro + Show 5 more

Open Access

https://doi.org/10.1590/s0104-42302009000500026

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Abstract

Gloves are the most important barriers that protect hospital personnel and patients. Unfortunately, glove perforation rates reach up to 78% in high risk procedures. The purpose of this prospective study was to evaluate the glove perforation rate in emergency procedures carried out in the Emergency Service of 'Santa Casa de São Paulo', School of Medicine. The study analyzed all gloves used in the emergency room during a 2 months period. Gloves were tested immediately after the surgical procedure using the approved standardized water leak method. A total of 252 surgical gloves used by residents in 42 surgical procedures and 2361 gloves used in emergency procedures were tested for the presence of punctures by the water insuflation method. Forty one (16.3%) of the gloves tested showed at least one puncture, 18 (33%) in traumatic emergencies. The overall perforation rate in the emergency room was 7,3%. We concluded that the incidence of punctures in gloves during surgical procedures was high, and occurred mostly with surgeons.

Highlights

The risk of contamination caused by occupational accidents among health care workers is a topic of great interest, among emergency service personnel, who are constantly exposed to blood, body fluids, cutting and perforating materials.[1,2,3,4]
Infections by hepatitis B and C viruses and human immunodeficiency virus transmitted through contaminated blood have been observed among health care workers after accidental exposure to the biological material, by means of percutaneous injuries and/or contact between mucous membrane or nonintact skin with infected blood
As of the 1980s, with the appearance of the AIDS epidemics, the Centers for Disease Control and Prevention (CDC) created the Universal/Standard Precautions, defined in 1987 as a set of rules to prevent the exposure of health care workers to pathogens transmitted by blood, given that it is not always possible to identify which patients represent risk, especially during emergency care.[5,6]

Summary

Introduction

The risk of contamination caused by occupational accidents among health care workers is a topic of great interest, among emergency service personnel, who are constantly exposed to blood, body fluids, cutting and perforating materials.[1,2,3,4]Infections by hepatitis B and C viruses and human immunodeficiency virus transmitted through contaminated blood have been observed among health care workers after accidental exposure to the biological material, by means of percutaneous injuries and/or contact between mucous membrane or nonintact skin with infected blood.As of the 1980s, with the appearance of the AIDS epidemics, the Centers for Disease Control and Prevention (CDC) created the Universal/Standard Precautions, defined in 1987 as a set of rules to prevent the exposure of health care workers to pathogens transmitted by blood, given that it is not always possible to identify which patients represent risk, especially during emergency care.[5,6]In Brazil, the National Health Surveillance Agency (Agência Nacional de Vigilância Sanitária, ANVISA), through RDC Resolution 5, of February 18, 2008, established minimum identity and quality criteria for national and imported gloves available in the national market.[7]Among precaution measures, the use of mask, eye shield, apron, impermeable boots, and two pairs of gloves (double gloving) seems to contribute significantly to reduce the contamination rate, by hepatitis B. gloves represent the main barrier between the surgeon and the patient, glove perforation is a common event and can reach the rate of 78%, especially during emergency, plastic, gynecologic, and orthopedic surgeries, which implies an increase in the risk of exposure.[8,9,10]. The risk of contamination caused by occupational accidents among health care workers is a topic of great interest, among emergency service personnel, who are constantly exposed to blood, body fluids, cutting and perforating materials.[1,2,3,4]. As of the 1980s, with the appearance of the AIDS epidemics, the Centers for Disease Control and Prevention (CDC) created the Universal/Standard Precautions, defined in 1987 as a set of rules to prevent the exposure of health care workers to pathogens transmitted by blood, given that it is not always possible to identify which patients represent risk, especially during emergency care.[5,6].

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