Powder-free Gloves Research Articles

Investigation of maximum torque values in manual tightening of dental implant healing screws

Aims: This study aimed to investigate the change of the maximum torque values applied by the dentist according to the parameters of gender,dental experience and glove type used in the tightening processes applied manually by pre-graduated and post-graduated dentists to the implant superstructure parts. Methods: 24 dentists (11 Male, 13 Female) participated in our study.Participants were instructed to tighten the implant healing screw (Straumann Dental Implant System, Waldenberg, Switzerland) placed on the digital torque measuring device(Cap torque tester series TT01; Mark10, Copiague, NY)by applying maximum force with a manual wrench.Powdered latex gloves,powderfree latex gloves and sterile surgical gloves were made available to the participants in order to imitate the mouth conditions as much as possible.Manual tightening was repeated three times in each group,with at least three minutes duration. Data were recorded digitally and statistical analysis was performed with IBS SPSS statistics 22 program.Independent sample t-test and one-way Anova analysis were used to evaluate differences between groups, followed by the post-hoc Tukey test. Results: Maximum torque value for tightening with powdered latex gloves (20.01±5.55) N, powder free latex gloves (17.27± 4.34) N and surgical gloves (20.27±6.02) N was found.In addition, we did not find a statistically significant difference in terms of gender and dental experience,which are the other parameters we investigated. Conclusion: Gender, experience and glove type do not statistically affect the maximum torque to be applied in implant superstructure applications.

Uncovering the Efficacy and Safety of Powder-Free Latex Examination Gloves and Powder-Free Nitrile Examination Gloves: A Post-Market Clinical Follow-up Study

This study evaluated the safety and performance of latex examination gloves powder free and nitrile examination gloves powder free. A total of 361 subjects participated in the study, with 181 using latex examination gloves powder free and 180 using nitrile examination gloves powder free. The performance of latex examination gloves powder free was rated as "satisfactory" (3.8) and that of nitrile examination gloves powder free as "good" (4.1). Clinical safety parameter analysis of latex examination gloves powder free showed that 87% of the users reported that the gloves did not fit perfectly. This may be due to the wrong size selection of gloves by the users for the procedure. No safety-related issues were reported by any of the users. No new risks were identified from the study for the products, and there was no addition to the residual risks that had already been identified in the Risk Management Report. None of the users reported any infection under normal condition of use, and there were no serious adverse events or adverse events reported. Keywords: latex examination gloves powder free, nitrile examination gloves powder free, safety, performance, clinical safety, risk management

A Comparison of Type IV Hypersensitivity Reaction to Synthetic Polyisoprene Gloves versus Control Gloves Using Modified Draize-95 Test in Normal Individual

Background: The emergence of epidemics in recent years, such as COVID-19 and monkeypox, has increased the need for protective gloves. Objectives: This study was performed to provide clinical evidence that no residual chemical additives are present in the powder-free, non-latex, with and without pigment, sterile and non-sterile nitrile, and polyisoprene gloves at a level that may induce type IV allergy in the unsensitized general user population. Methods and Materials: We conducted the modified Draize-95 test on the GAMMEX® Non-Latex PI, sterile powder-free synthetic polyisoprene surgical gloves (S01) and the GAMMEX® Non-Latex PI Green, sterile powder free synthetic polyisoprene surgical gloves (S02). A quasi-experimental non-equivalent study consisted of 180 healthy unsensitized adult volunteers at the Islamic University of Gaza. Participants were divided into two groups: 150 white subjects and 30 black subjects. Each group divided into two groups, each one contained approximately the same numbers of males and females. We used two sets of different test materials as 2x2 cm pieces of the glove's materials from the inner and outer surfaces mounted on an adhesive patch. For the control groups, we used Nitrile Skin Examination Powder-Free Disposable Gloves (C1) and Aegis Examination Gloves (C2). Results: None of the participants showed positive reactions to the test materials of equal or greater than 1.5 in the challenge or rechallenge phase, both on the inner and outer surfaces of the GAMMEX® Non-Latex PI, sterile powder-free synthetic polyisoprene surgical gloves (S01), and the GAMMEX® Non-Latex PI Green, sterile powder-free synthetic polyisoprene surgical gloves (S02). Only one white woman showed a reaction to the inner surface of the S02 material in the induction phase. Three participants showed skin reactions to the second control material, the Aegis Nitrile Examination Gloves (C2). Those three were a white female in the induction phase and two white males in the challenge phase. However, none of them showed any reaction later. Conclusion: The modified Draize test negative results for the GAMMEX Non-Latex PI, sterile powder-free, synthetic polyisoprene surgical gloves (white and green) support the claim that the chemical sensitization potential of these materials is low and that no residual chemical additives are present in these gloves at a level that could cause type IV hypersensitivity reactions.

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

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.. 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. 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). 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). 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.

Evaluation of the Efficacy of Nitrile Gloves Exposed to Chemical Germicide on Medical Devices in Central Sterile Services Department

Nitrile gloves are commonly used in Central Sterile Services Department in order to be often used when manually cleaning medical equipment such as personal protective equipment. As a result they are resistant to a wide range of chemicals and germicides, including alcohols, peroxides, and other sterilizing agents. In addition to providing chemical protection, nitrile gloves are resistant to punctures and tears, which is important when working with sharp medical instruments. This research focuses on the efficacy of gloves in relation to the multi-chemicals or compounds of nitrile gloves and observation at the point of use to remove soil and contact with chemicals on medical devices at the Central Sterile Supply Department. The powder-free nitrile exam gloves and extended cuff methods of chemical analysis of permeation testing of standard practice for assessment of resistance of medical gloves to permeation by chemotherapy drugs (ASTM D 6978-05), EN455 Part 1: 2000 were used to test the test method for single-use medical gloves. The standard of protective gloves against dangerous chemicals and microorganisms was tested by EN 420:2003 + A1:2009, EN388: 2016, ISO 374-1:2016, and ISO 374-5:2016. The testing of chemotherapy drugs and UV/NIS absorption spectrometry were used to measure the absorbance of test chemicals, which permeated through the specimens into the collection medium. The collection medium was circulated in a closed loop at an 11 ml/minute flow rate through the testing period. As a result, a glove user must protect against the specific chemicals or chemical mixtures to which they were exposed while manually cleaning medical devices. The physical properties of the gloves were evaluated by visual observations at the point of use for soil removal and chemical exposure to medical devices at the Central Sterile Supply Department of five hospitals. The results showed that nitrile gloves protected chemical exposure during manual cleaning of medical equipment at the point of use.

1376 Latex Allergies: Seeking an Alternative to Minimise Risk in The Operating Theatre

Abstract Introduction Natural Rubber Latex (NRL) gloves have been ubiquitously used in surgical practice. Over the past few decades, there have been many reports of NRL allergies associated with their use presenting a safety hazard to both patients and healthcare workers. Powder-free and latex-free gloves have been shown to offer reductions in incidence of allergic reactions, as well as cost savings. Method We performed a literature search to identify the rates of reaction to latex across the population in addition to the associated costs including litigation costs, costs of admission, and lost work time associated. We further looked at the rates of perforation of alternatives and the costs associated with such a transition. Results The UK prevalence of sensitisation amongst healthcare workers has been estimated to be 10%. The average cost of litigation to the employer was found to be $21,402 per claim. The mean cost of inpatient care for anaphylaxis has been cited as £469.88, with additional costs such as follow-up representing approximately £400. A 14-month study found cost savings of $10,000pa with a switch to non-latex gloves. Furthermore, an overall perforation rate of 80% in a latex-free glove compared to 34.4% in a latex glove. Conclusions From a business perspective, there is evidence of cost-savings arising from a switch to latex-free gloves, however, formal cost-effectiveness analyses would inform future decisions. Furthermore, comfort and reducing the chances of allergic reactions through removing the offending allergen all represent benefits of switching to latex-free gloves, however, non-inferiority analyses will inform future strategies both locally and nationally.

Role and responsibility of operating room nurse in preparation operation theatre for HIPEC and cytoreductive surgery in the tertiary health center in north India

Hyperthermic (or Heated) Intraperitoneal Chemotherapy (HIPEC) is a surgical procedure that’s giving new hope to patients with abdominal cancers. Immediately after removing visible tumors through cytoreductive surgery, surgeons give a dose of heated chemotherapy inside a patient’s abdomen. The technique involves macroscopic resection of disease burden and metastases, followed by infusion of chemotherapy heated to 41°C–43°C into the peritoneal cavity through a special device. After 90 minutes of the infusion, the chemo is washed out and incisions are closed. Chemotherapy: -In HIPAC (Intraperitoneal) mitomycin-c is the most common drug administrated and platinum-based drugs, cisplatin, carboplatin, and oxaliplatin which have a synergistic effect with heat, and doxorubicin, paclitaxel, docetaxel, and 5-fluorouracil drugs are commonly less used. The technique of Hyperthermic intraperitoneal chemotherapy Administration: HIPEC is administrated by two classical methods, the open abdomen method, and the closed method. Skin preparation of patient: Skin preparation is from the mid-chest to midthigh with the preparation of the genitalia and catheterization.Safety guidelines for administration of HIPEC: A sign the HIPEC is in progress should be placed at the door and the entry of personnel not involved in the procedure should be restricted. N95 grade mask provides the best protection against surgical smoke produced during the use of electrocautery. Doors should be closed during the operation with pressurized closures. The temperature should be 18–26 degrees Celsius and air humidity 45–60 %. The Association for peri-Operative Registered Nurses (AORN) recommends that operating room air exchanges should be maintained at a minimum of 15 air exchanges per hour. Air inflow volume should be 15 % higher than the outflow, airspeed must be lesser than 0.3 m/s. Appropriate PPE (personal protective equipment) consists of an N95 face mask (a simple surgical mask does not provide adequate protection), gloves, protective gown, and overshoes or laggings to provide adequate protection to all involved team members.Handling of the chemotherapy during HIPEC: it should be prepared in the bio-safety cabinet not in the ward because of the danger from spillage and contamination, while preparing cytotoxic drugs to wear nitrile or neoprene powder-free long cuff gloves and wear a gown non-permeable long sleeve, cuffed and solid fronted and use an aerosol-free mask. Every effort should be taken to avoid any spill. Hospital policies to prevent spills should be adopted by the surgical and operation theatre team members and written procedures must specify the team responsible for spill management. Health care institutions should develop a plan and policy for handling hazardous medications. Collection, labeling, storage, transport, and disposal of contaminated waste should be done as per hospital policy.Cleaning the operating room after HIPEC: Soap water is adequate to clean the operating room after HIPEC three consecutive times. 70% of isopropyl alcohol is also safe and effective.Conclusions: All available studies point out that the correct use of specific protective measures is a key factor to minimize exposure. Emphasis has to be also placed on educating and instructing the involved personnel in the hazards and safe use of chemotherapy, the importance of adherence to safety protocols, and the correct use of the recommended personal protective equipment.

Impact of replacing powdered gloves with powder-free gloves on hand-hygiene compliance among healthcare workers of an intensive care unit: a quasi-experimental study

Background/objectiveAfter wearing powdered gloves, healthcare workers (HCW) are supposed to wash their hands instead of using alcohol-based hand-rub (ABHR). Washing hands takes longer than using ABHR, and the use of powdered gloves may be an obstacle to hand-hygiene compliance. This study aimed to evaluate the impact of replacing powdered gloves with powder-free gloves on hand-hygiene compliance among HCW of an intensive care unit (ICU).MethodsA quasi-experimental study was conducted in a general ICU of a tertiary care university hospital in Brazil. From June 1st to July 15th, 2017, all HCW were provided with powdered latex gloves only for all clinical procedures. From July 15th to August 31st, 2017, HCW were provided with nitrile powder-free gloves only. Hand-hygiene compliance was assessed through direct observation, and evaluated according to the World Health Organization Hand Hygiene guidelines. We calculated that a sample size of 544 hand hygiene opportunities needed to be observed per period. Data analysis were performed using the STATA SE® version 14, and we compared the individual’s percentage of compliance using the t test for paired data before and after the intervention.ResultsOverall, 40 HCW were assessed before and after the introduction of nitrile powder-free gloves, with 1114 and 1139 observations of hand hygiene opportunities, respectively. The proportion of compliance with hand hygiene was 55% (95% confidence interval [CI] 51–59%) using powdered latex gloves and 60% (95% CI 57–63%) using powder-free gloves. The difference in proportions between the two types of gloves was 5.1% (95% CI 2.5–7.6%, p < 0.001).ConclusionOur data indicate that replacing powdered gloves with powder-free gloves positively influenced hand-hygiene compliance by HCW in an ICU setting.

Evolution of the medical devices for the protection of healthcare workers. Prevention of hemocontact infections in patients with an uncertain status

Background. Personal protective equipment (PPE) is an item of clothing designed to protect healthcare workers (HCW) or others from infection. PPE includes gloves, masks, gowns, respirators, goggles, face shields, headgear, boot covers, rubber shoes, and more.&#x0D; Objective. To describe the evolution of medical devices for HCW protection.&#x0D; Materials and methods. Review of literature data on this issue.&#x0D; Results and discussion. Medical gloves are divided into sterile and non-sterile. The purpose of wearing non-sterile gloves is to prevent contamination of the hands of HCW with microorganisms. They should be worn when there is a risk of contact with blood or other body fluids, patient secretions, or contaminated equipment. Gloves do not protect against contamination and after their use it is still necessary to treat hands with antiseptic. Latex gloves have good elasticity and flexibility, are convenient and anatomically suitable for hands, have a good sensitivity to touch. However, they can cause allergies or skin irritation. Latex allergy is the most common cause of perioperative anaphylaxis in children. It is recommended to use powder-free gloves. Nitrile gloves for examination manufactured by “Yuria-Pharm” are characterized by high toughness, elongated cuff, and special texture facilitating holding the instruments. Surgical masks consist of three layers of thermoplastic polymer located between the layers of nonwoven fabric. They are designed to protect against pathogens (mainly bacteria) transmitted in large droplets (&gt;5 μm). The Cochrane review did not show any convincing effect of wearing of surgical masks on reducing the risk of infectious complications during sterile surgical procedures. WHO recommends wearing surgical masks to prevent the transmission of coronavirus disease (COVID-19). N95 or FFP3 class respirators are recommended for aerosol-generating procedures (tracheal intubation, bronchoscopy) and for dangerous infections. N95 respirators are the standard for working with patients with COVID-19 in USA. They can be with a valve or without it. These respirators consist of thermoplastic polymer and nonwoven fabric and filter 95 % of particles sized ≥0.3 μm. They should tightly fit to the face and be tested for leaks before the contact with patient. A similar tactic should be used when wearing FFP3 respirator. Valve respirators are easier to use because the presence of a valve facilitates exhalation. The valve also increases comfort and prevents excessive accumulation of moisture under the respirator. Such respirators do not filter the exhaled air, so they do not protect others from infection. Another field of PPE application is its usage in hematocontact infections caused by hepatitis B/C virus and human immunodeficiency virus. The risk of HCW infection is associated with pricks, cuts, contact with the patient’s body fluids, and any invasive diagnostic or treatment procedures. The risk of patient’s infection is present in case of the improper instruments sterilization, use of non-sterile infusion solutions, transfusion of blood and its components, transplantation, and contact with biological fluids of the infected HCW. To reduce the risk of HCW infection, always wear gloves if there is a risk of contact with blood or other body fluids; never put the cap on the needle after using it; always keep a container for sharp objects on hand; carry out the necessary vaccinations; use PPE and safety needles, scalpels and syringes.&#x0D; Conclusions. 1. Wearing masks reduces the risk of COVID-19 transmission. 2. During aerosol-generating procedures it is necessary to use all available PPE. 3. When wearing a respirator, it is advisable to check its tightness. 4. The number of extra injections should be minimized.

Infection prevention and waste management audit in the MCH department -Busia County Referral Hospital July 2019

Background: The primary principle of IPC describes a series of safe methods to ensure the protection of those vulnerable to acquiring Nosocomial infections in health care Settings. Methods and materials: We conducted a departmental walkthrough/audit to determine compliance and commitment of the MCH department staff and its users to infection prevention/waste management practises. The following areas were assessed; availability of hand washing facilities, segregation of wastes, availability and appropriate use of personal protective equipment (PPEs),trainings and capacity building, immunization status of staffs and environmental sanitation. Aim was to describe compliance to IPC/Waste management practices among MCH Department users by: Person's i.e,Technical Staff, Interns/Students, Support staff. Place, MCH departments Results: Results/Findings‘ There were hand washing stations in 5 (50%) 0f the 10 sections at the MCH department ie, Immunization room, Patients clerking room, PMTCT room, Pharmacy and the Laboratory section. However, Patients waiting bay, Registration room, Nutritional support, Cold room and HTS rooms had no hand washing facilities at all. All the patients attending MCH clinic lacked information on hand washing stations in the department whereas all the staffs knew at least where to hand wash however, distribution was inconsistent. Waste segregation was poor across all the sections in the MCH department. Availability of sharp boxes 100%, Availability of 3 colour code bins 0%, Proper segregation of wastes 0%. Availability of Personal Protective Equipment (PPEs) stands at 50% & the main challenge was in the Immunization section (No powder free gloves) whereas PPE usage was at 26% (5) out of 19 (74%) staff (including students interns) were in proper PPEs. 36% (7) of the staff on duty had received at least a dose of Hepatitis B vaccine though none of them had completed the 3 doses. MCH department environmental cleanliness was good. However, there is need to erect a signage to direct patients on the disposal of used cotton swabs in the waste receptacle outside the department. Conclusion: There is need to strengthen IPC and waste segregation practices in the department and entire Hospital. Handwashing is key in infection prevention therefore hand washing facilities should be installed in all sections.

Detection of gasoline on suspects’ hands: Study of different sampling alternatives

Arsonists may use ignitable liquids to start, accelerate and amplify fires. The sampling of volatiles present on the hands of suspected arsonists is therefore sometimes carried out in the course of the investigation of (possible) deliberate fires. Several collection protocols have been proposed, relying on the concentration of volatiles by the transfer on PVC gloves and further passive headspace extraction with Activated Charcoal Strips (ACS). Previous research findings assessing the use of Activated Carbon Cloth (ACC) – initially developed for the adsorption of gas in military applications – opens the path to new perspectives regarding the extraction and the concentration of ignitable liquid residues in general, and for the sampling on hands in particular. Five alternative methods (four relying on the use of ACC and one on ACS) were considered for the collection of gasoline traces present on the hands and their subsequent analysis by gas chromatography – mass spectrometry.Gasoline was deposited onto the palms of volunteers to study the differences between the collection method using ACS and those using ACC. For the latter, either the volunteer hands were placed in nylon bags with an ACC on the palm or suspended, or, powder-free latex gloves were used, with an ACC on the palm or in a separate extraction, with the glove in a nylon bag and the ACC suspended.The results showed that the background contamination was not distinguishable between ACS and ACC and their sampling ability was comparable. The two methods relying on the deposition of ACC directly on the surface of the palm where gasoline was deposited showed significantly higher collection capacity than other methods, provided that the ACC was in direct contact with the contaminated zone. The results showed that three main factors affected the collection of gasoline on the hands: the distance between the skin and the sorbent (ACC or ACS) in case of direct concentration of volatiles on the sorbent, the exposure time, and the space between the hand and the glove or bag (i.e. the headspace volume).This research opens new perspectives for the sampling of ignitable liquid residues through the use of ACC. It corroborates the perceived potential of ACC for the extraction and concentration of volatile compounds, particularly for fire debris analysis purposes. While the experiments were focused on the collection of gasoline on hands, the results provide valuable information in a more general way for the sampling of fire debris.

Disinfection of gloved hands during the COVID-19 pandemic

BackgroundDisinfection 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.AimTo test the resistance of nitrile gloves to various disinfectant solutions.MethodsOne 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.FindingsBleach solution decreased the breaking load of gloves, although to a lesser extent than disinfectants that contained ethanol.ConclusionDisinfectants that contain alcohol decrease the breaking load of nitrile gloves.

Diffuse lamellar keratitis after LASIK with low-energy femtosecond laser.

To evaluate the incidence, evolution, and prognosis of diffuse lamellar keratitis (DLK) in a large series of laser in situ keratomileusis (LASIK) with low-energy femtosecond laser. Private practice, Siena, Italy. Retrospective, consecutive, noncomparative case series study. Single-use instruments, powder-free gloves, and no corneal marking were used. Flap was created by a low-energy femtosecond laser (Ziemer Z2 and Z4). A total of 37 315 eyes of 19 602 patients were reviewed. DLK was observed in 236 eyes (0.63%) of 149 patients (0.76%). Grade 1 DLK was observed in 231 eyes of 142 patients, grade 2 in 1 eye: when treated with topical steroids, they had no visual consequences. Three patients had bilateral grade 3 to 4 DLK: one of them, with bilateral grade 3, despite flap lifting and irrigation worsened to stage 4 (central stroma thinning and flattening), partially recovered in 2 years, and underwent repeat femtosecond laser-assisted LASIK for hyperopic shift in 1 eye. In all the 5 eyes that developed grade 4 DLK, corneal thickness decreased until the first month and then partially recovered; mean final tissue loss at 1 to 2 years was 35 µm. Compensatory epithelial thickening was observed. DLK after low-energy femtosecond laser-assisted LASIK is rare; severe DLK (stages 3 and 4) was found in only 6 eyes (0.016%). Flap lifting and irrigation might not prevent progression. Spontaneous reformation of stromal tissue and epithelial thickening improve visual acuity in the long term; residual hyperopic shift can be corrected by repeat femtosecond laser-assisted LASIK.

Fentanyl and carfentanil permeation through commercial disposable gloves

In 2018, the Centers for Disease Control and Prevention reported that opioid overdose deaths (including fentanyl and carfentanil) comprised 46,802 (69%) of the 67,367 total drug overdose deaths. The opioid overdose epidemic affects Americans not only at home but also in the workplace. First responders may be at risk of opioid exposure during incidents such as vehicle searches and responses to overdose calls. To reduce direct exposure to opioids and other hazardous drugs, first responders rely in part on personal protective equipment (PPE) as their last line of defense. First responders seek guidance from the National Institute for Occupational Safety and Health (NIOSH) regarding appropriate PPE selection for potential opioid exposure. There is limited empirical glove performance data for illicit drugs. Empirical data are needed to validate NIOSH’s current recommendations regarding gloves to help prevent exposure to illicit drugs (i.e., powder-free nitrile gloves with a minimum thickness of 5 ± 2 mil [0.127 ± 0.051 millimeters]); however, no industry standard or test method currently exists for specifically evaluating PPE performance against fentanyl and its analogs. To understand the permeation qualities of gloves when challenged against fentanyl and carfentanil solutions, the ASTM International (formerly American Society for Testing and Materials) ASTM D6978-19 standard for chemotherapy drug glove permeation was adapted to test fentanyl and carfentanil hydrochloride solution permeation through twelve disposable glove models, including five models in which the manufacturers claim fentanyl protection. No nitrile glove models showed fentanyl or carfentanil permeation rates above the chemotherapy drug threshold criterion of 0.01 µg/cm2/min (i.e., thereby meeting the performance requirement) as calculated using the ASTM D6978-19 standard within the 240-min test. Latex and vinyl glove materials exhibited fentanyl and carfentanil permeation with permeation rates above this threshold. These findings are among the first empirical data to support NIOSH’s current opioid glove recommendations and define procedures that could be used to support industry standards for evaluating opioid permeation through air-impermeable PPE materials.

Effectiveness of surgical hand antisepsis using chlorhexidine digluconate and parachlorometaxylenol hand scrub: Cross-over trial.

Background:Chlorhexidine and parachlorometaxylenol (PCMX) are antiseptics recommended for surgical hand antisepsis. To our knowledge, PCMX has not been evaluated for bactericidal efficacy “in vivo.Methods:We conducted a randomized, double-blind, controlled crossover trial to compare the bacterial loads on fingertips and fingernails under laboratory conditions after use of antiseptic test products, including chlorhexidine digluconate 4%, PCMX 3%, and a reference solution of propan-1-ol 60% (P-1). We assessed bacterial load after a prewash with soft soap, immediately after application of an antiseptic, and 3 hours after application and wearing of sterile, powder-free gloves. Our procedures followed those specified by European Norm (EN) 12791 for evaluating surgical hand antiseptics and using cotton swab for fingertips and fingernails.Results:Chlorhexidine digluconate 4% and PCMX 3% did not decrease bacterial load on the hands. The bactericidal performances of chlorhexidine digluconate 4% and PCMX 3% did not differ significantly. Chlorhexidine digluconate 4% and PCMX 3% increased bacterial load on the fingertips after participants had worn gloves for 3 hours. Fingernails had greater bacterial loads than skin on the fingertips.Conclusions:Chlorhexidine digluconate 4% and PCMX 3% had similar bactericidal efficacy, but they failed to meet the EN 12791 efficacy standard. Fingernails should be a particular focus of antisepsis in preparation for surgery.The trial was registered at ClinicalTrials.gov (ID: NCT02500758).

Evidence-Based Implementation of Peripherally Inserted Central Catheters (PICCs) Insertion at a Vascular Access Care Outpatient Clinic.

Evidence-Based Implementation of Peripherally Inserted Central Catheters (PICCs) Insertion at a Vascular Access Care Outpatient Clinic.

A Collective Review on Hazards of Powder on Surgical and Examination Gloves.

This article reviews information on the hazards associated with dusting powders on latex surgical and examination gloves. Dusting powders were first applied to latex gloves to facilitate donning. After 1980, manufacturers devised innovative techniques to manufacture gloves without dusting powders. It has been well documented that the powders on gloves present a health hazard to patients, as well as to operating-room personnel. First, these powders elicit tissue toxicity in every tissue in the body. Second, these powders serve as carriers of latex allergen and may precipitate a life-threatening allergic reaction in sensitized patients. These well-documented hazards of glove powders have caused a growing number of hospitals in the world to abandon the use of examination and surgical gloves coated with powder, and instead to use only powder-free gloves.

Kinetics of Powder-Free Laboratory Examination Gloves at 323°C and 408°C by Thermogravimetric Analysis

Kinetics of Powder-Free Laboratory Examination Gloves at 323°C and 408°C by Thermogravimetric Analysis

Kinetics of Powder-Free Laboratory Examination Gloves at 345°C and 405°C by Thermogravimetric Analysis

Kinetics of Powder-Free Laboratory Examination Gloves at 345°C and 405°C by Thermogravimetric Analysis

Contamination of Composite Resin by Glove Powder and Saliva Contaminants: Impact on Mechanical Properties and Incremental Layer Debonding.

This study investigated the influence of digital manipulation of a composite resin (Z250; 3M ESPE, St Paul, MN, USA) with gloves contaminated with powder and/or human stimulated saliva on the mechanical properties and incremental layer debonding of the restorative. The six groups tested were powdered gloves with or without saliva, powder-free gloves with or without saliva, powdered gloves with saliva cleaned with 70% ethanol, and no digital manipulation or contamination (control). Diametral tensile strength, flexural strength, flexural modulus, and incremental layer shear bond strength were evaluated. Each composite increment was digitally manipulated for 10 seconds. Data from each test were separately analyzed using analysis of variance and the Student-Newman-Keuls test (α=0.05). No significant differences for diametral tensile strength were observed. Manipulation of the composite using powder-free gloves with saliva or using gloves cleaned with ethanol generated higher flexural strength and modulus compared to the other groups. The control group and the group manipulated using powdered gloves with saliva generally showed lower mechanical performances. Lower incremental layer bond strength was observed for the group manipulated with powdered gloves without saliva. The control group and the groups manipulated with powdered gloves with saliva or cleaned with ethanol showed higher shear bond strengths. Most of the failures were cohesive. In conclusion, digital manipulation might be important for the composite resin to achieve better mechanical performance and incremental layer bond strength, provided that the gloves are not contaminated. Cleaning the gloves with ethanol might avoid the negative effects of digital manipulation using contaminated gloves.