Sterile Latex Research Articles

Examination of several instruments for the electrical detection of holes in latex gloves during use.

The initial purpose of this research was to investigate the use of electrical conductivity for detecting holes in latex gloves, while they are being worn, using both recently developed devices and laboratory equipment. The individual devices were not evaluated or critically compared. The use of this technique as a quality assurance procedure, and to determine the degradation of latex gloves due to storage and exposure to disinfectants, was also investigated. The following conclusions were reached: (1) These devices alarm if the latex is breached by an object of at least 300 um-diameter and both the inside and outside of the glove are wet with a conductive fluid. False alarms from latex hydration is the primary disadvantage. (2) This technique is a sensitive QA procedure if any hole to be detected is wet with a conductive liquid. (3) Sealed, sterile latex gloves may degrade over many months. (4) There was no obvious degradation of latex gloves after two hours' exposure to three commonly used disinfectants.

Induction and localization of FAD-glucose dehydrogenase (GLD) during encapsulation of abiotic implants in Manduca sexta larvae

FAD-Glucose dehydrogenase (GLD) (EC 1.1.99.10) was assayed during the encapsulation response against abiotic implants (sterile latex) in fourth instar Manduca sexta larvae. No GLD activity was detected in fresh hemolymph or hemocytes of control or sham-treated larvae. Two types of responses occurred at 0.5 and 3 h after implantation. In the majority of larvae, only the encapsulation had high levels of GLD specific activity. In the second response, low levels of GLD specific activity were detected in hemocytes and cell-free hemolymph but not in the encapsulation. By 24 h after implantation, GLD activity was detected in the encapsulation tissue of all larvae. Levels of GLD specific activity did not significantly differ over time (0.5–72 h) during encapsulation. Freezing cell-free hemolymph from control larvae activated otherwise inactive hemolymph stores of GLD. In vitro experiments and histochemical staining demonstrated that GLD activity was localized in granules of plasmatocytes adhered to coverslips. Granules of both plasmatocytes and granulocytes contained GLD protein as detected by immunohistochemistry. Based on previous characterization of GLD, we hypothesize that GLD participates in strengthening the encapsulation and in the killing reaction, via reaction with quinones generated by phenoloxidase and subsequent production of free radicals.

Use of a latex cover sheath for transesophageal echocardiography (TEE) instead of regular disinfection of the echoscope?

Better visualization of cardiac structures is an advantage of transesophageal echocardiography (TEE). Because of this, the transesophageal approach is an essential window in the assessment of various cardiovascular disorders. Quick consecutive access to this instrument should not be delayed by time-consuming cleansing procedures of the probe. In this study we used a sterile latex condom in routine TEE examinations as a barrier to contamination of the echoscope, observing practical use and the incidence of perforations. Defects were detected after the procedure by visual inspection and by an airtightness test. Maneuvers or situations associated with an increased likelihood of injury were checked for. In 180 studies a total of 168 patients were consecutively examined; insertion was feasible in all but one case (99.5%). We found 8 of 181 (4.4%) sheaths defective following the procedure. Visual inspection was less sensitive (only 3 of 8) for finding defects than an airtightness test (8 times). Teeth in situ and/or a bite guard are the only sharp edges during insertion and removing the probe; these seem to be the main risk factors in latex perforation. Application of a cover sheath for each examination saves approximately two-thirds of the time otherwise necessary for a cleansing bath, and easy handling of cover sheaths for TEE make them an alternative to regular disinfection in general. For reasons of safety we recommend checking each used cover sheath after examination for holes so as not to jeopardize the following patient by the possible spread of germs from contaminated probes. Not only visual inspection but also a second method, for example, an airtightness test, is mandatory.

Proper probe size for pediatric transesophageal echocardiography

L arge “adult size” transesophageal echocardiographic (TEE) probes have been used for examination of older children and adults with congenital and acquired heart disease. More recently, smaller “pediatric” TEE probes have become available, allowing TEE examination of smaller subjects. Although references in published reports indicate that the larger probes “can be used safely in larger children (>20 kg),” and that pediatric probes have been used in infants weighing as little as 2.4 to 6.5 kg,1-3 little information exists regarding the safety of widespread use of probes of different size in the pediatric population. We reviewed a consecutive series of 346 TEE examinations at Children’s Hospital and Medical Center Seattle. Most of the patients (332 of 346) were examined intraoperatively, with the remainder examined in the intensive care unit or cardiac catheterization laboratory. Examinations conformed to Guidelines established for TEE examination in children.4 At each examination, report forms were completed, including data regarding patient and probe size, ease of probe insertion, and complications. These reports form the data base for this review. Ultrasound instrumentation used in this series included Siemens SI-1200, Hewlett-Packard Sonos 1000, and Toshiba SSH-140 systems. The pediatric probes had shaft diameters of 6.0 to 7.0 mm, and distal transducer tip dimensions of 7 X 10 mm or 6 X 13 mm. The “adult” probes had a shaft diameter of 9.8 mm, with distal tip dimension of 11 X 15 mm. These probes, previously disinfected with Cidex (Johnson & Johnson, Arlington, Texas), were placed in a sterile latex sheath (Civco, Kalowna, Iowa) whose tip had been filled with ultrasonic gel (Aquasonic, Parker Labs, Orange, New Jersey). The gel-filled sheath was massaged to distribute the gel in a thin layer within the sheath, and to prevent any bulbous accumulation of the gel within the sheath. The sheath-covered probes were lightly lubricated (Surgilube, E. E Fougera, Melville, New York), and inserted manually, usually without laryngoscopic visualization. Upon removal of the TEE probes, the external aspect of the sheath was inspected, and the report form completed. Complications, which included inability to insert the TEE probe, were noted. Ease of insertion was graded on a 1 to 5 scale (1 = easy insertion, 5 = most dtficult). Statistical analysis was performed using Fisher’s exact test (Fish 6, Wm. Engels, University of Wisconsin, Madison, Wisconsin).

Characteristics of inert beads provoking humoral immune responses in Galleria mellonella larvae

Injection of ion exchange beads or sterile latex beads into the haemocoel of wax moth ( Galleria mellonella) larvae provokes an humoral immune response measurable as antibacterial activity in cell-free haemolymph. The influence of provocator surface properties on the intensity of response was investigated. Comparing the antibacterial activities provoked by injection of anion and cation exchangers it can be concluded, that anion exchangers are better provocators than cation exchangers. The influence of physicochemical parameters was confirmed by the fact, that injection of latex beads pretreated with sulphuric acid lead to enhanced antibacterial activities in larvae as compared to the activities provoked by injection of untreated beads. In order to prove if it is possible to enhance the provocation capacity of beads by binding molecules to their surfaces, the following substances were covalently coupled onto the beads prior to injection: fibronectin, peptides with a cell adhesive signal of fibronectin (GLY-ARG-GLY-ASP-SER-PRO-LYS, GLY-ARG-GLY-ASP-SER, ARG-GLY-ASP-SER), poly-lysine, adjuvant peptide, lysozyme, bovine serum albumin, bovine plasma, cell-free haemolymph and haemolymph lysate supernatant (haemolymph preparations from G. mellonella) Coupling of adjuvant peptide, fibronectin or haemolymph preparations enhanced the provocation capacity of beads very clearly. Likewise, but to a lower extent, an enhancement was noticed for nearly all the other substances tested in comparison to results obtained by injection of unloaded beads. The results will be discussed in relation to the known facts about the influence of provocator characteristics onto the onset of a cellular reaction by arthropod and vertebrate cells.

Induction of immunity by latex beads and by hemolymph transfer in Galleria mellonella

Injection of sterile latex beads into the hemocoel of last instar larvae of Galleria mellonella provoked a strong defense reaction. Cellular defense by hemocytes was followed by enhanced antibacterial activity in hemolymph. Latex-injected insects showed increased survival rates after a challenge injection with high doses of bacteria. Factors which stimulate the production of antibacterial activity could be demonstrated soon after injection by transfer of hemolymph from preinjected to untreated larvae. A large induction capacity in donor hemolymph was accompanied by a strong decrease in the total hemocyte count of free floating hemocytes, resulting from a decrease in number of plasmatocytes and granular cells, the cell types involved in the cellular defense against the injected latex beads. The results presented support the hypothesis that during cellular defense reactions, factors are released from the hemocytes which stimulate the production of antibacterial substances.

Efficacy of glove combinations in reducing cell culture infection after glove puncture with needles contaminated with human immunodeficiency virus type 1.

To study the effect of various latex and treated glove combinations in reducing the frequency of human immunodeficiency virus (HIV) infection of tissue culture cells after puncture by surgical needles contaminated with infectious human immunodeficiency virus type 1 (HIV-1). One, two, or three layers of sterile latex glove material, or two latex layers with intermediate cotton or Kevlar (with or without the virucidal compound nonoxynol-9) were used to cover 24-well cell culture dishes containing MT2 cells in cell culture medium. Surgical needles wet with cell culture medium containing HIV-1 (HTLV IIIA strain) were passed through the glove materials into the culture medium in the wells of the culture dishes. The culture medium in each well was then assayed biweekly for HIV-1 p24 antigen as a test for infection of cells in the well. The rate of HIV-1 infection of cell cultures after glove puncture was greater than 90% with a single latex surgical glove barrier, 23% to 60% with double or triple layers of latex gloves, less than 8% with an intermediate cotton glove impregnated with 4% nonoxynol-9, 6% with an intermediate Kevlar glove, and 0% with an intermediate Kevlar glove impregnated with nonoxynol-9. An intermediate glove of Kevlar or of Kevlar or cotton impregnated with virucidal compound nonoxynol-9 between standard latex gloves may improve surgical glove safety, compared with latex gloves alone with respect to needlestick transmission of HIV-1. The experimental model used may permit rapid investigation of other glove systems as barriers to the transfer of infectious agents through gloves by needlestick.

Ingestion and regurgitation of living and inert materials by the estuarine copepod Eurytemora affinis (Poppe) and the influence of salinity

Eurytemora affinis (Poppe) fed on cultured Thalassiosira weissflogii (Grunnow) at rates of 200–34000 cells copepod −1 h −1. Feeding was delayed and diminished in bright light. In dim light, feeding was initially faster in 15‰ (27000–34000 copepod −1 h −1) than in 10‰ (23000–25000 copepod −1 h −1) and much faster than in 3‰ (6000 copepod −1 h −1). After 1–3 h, feeding continued more steadily in 3‰ (1200–6500 copepod −1 h −1) but slowed drastically in 10 and 15‰ to 200–5000 copepod −1 h −1). These patterns were maintained when copepods were first acclimated briefly to the test salinities. E. affinis fed at slightly higher rates on sterile latex beads of similar size to T. weissfloggi, fastest in 10‰ and slowest in 3‰. While the beads appeared in the guts, they did not appear in the faecal pellets and after 1 h (10, 15‰) or 3 h (3‰), their numbers in suspension recovered close to original counts. In contrast, beads infected with a marine bacterium were similarly eaten (at slightly higher rates than the sterile beads), and appeared in the guts and then in the faecal pellets, while numbers in suspension continued to fall or remained low. The contrasts between initial rapid feeding in 10–15‰ and slower steadier feeding in 3‰, and between regurgitation of swallowed sterile beads and passage through the gut of bacterially-contaminated beads, have significance for the biology of a copepod living in the upper reaches of an estuary.

Soap pH and the effectiveness of alcoholic hand antiseptics.

This study was done to investigate if the pH-value of a soap used for handwashing had any effect on the immediate and the prolonged effectiveness of alcoholic hand disinfectants. One acidic soap (pH = 3.5) and one alkaline soap (pH = 8.5) were tested in combination with 70% and 90% ethanol and alcoholic chlorhexidine. Bacterial counts from the hands of 26 test persons were obtained using the fingerprint method. The fingerprints were taken before and after handwashing, after hand disinfection and after 3 h of wearing sterile latex gloves. The results showed that soap pH did not influence significantly the effectiveness of a subsequent hand disinfection. The combined use of alkaline soap and alcoholic chlorhexidine showed a tendency to smaller variation in bacterial reduction and greater effectiveness. This combination was the only one that led to an increased bacterial reduction after 3 h.

Permeability of latex and vinyl gloves to water and blood

Two thousand four hundred medical gloves were evaluated for leakage. Types of gloves examined (number of brands) included sterile latex (seven) sterile vinyl (four), nonsterile latex (six), and nonsterile vinyl (seven). Sampling was done from one box of each brand. Fifty gloves from each box were filled with 300 ml of water (the standard test used by the American Society for Testing and Materials). An additional 25 cm pressure was applied to water-filled gloves. Another 50 gloves of each box were donned and dipped into a basin that contained heparinized human blood. Only four brands of sterile latex surgeon's gloves proved nonpermeable to water and blood. Other brands showed leakage that ranged from 1% to 52%. Analysis of proportions of pairs of gloves permeable to water or blood indicated a strong statistical association of nonsterile packaging or packaging in suction kits with increased leakage rates. These findings affirm that gloves can be regarded only as a means of reducing the risk of gross soilage from blood or body fluids. Quality control standards to ensure more uniform glove quality are needed.

Pyrogens from surgeons' sterile latex gloves.

Pyrogens have been detected in water extracts from surgeons' sterile latex gloves, using both the Limulus Amebocyte Lysate (LAL) test and the rabbit test. After the gloves were rinsed with pyrogen-free water, the amount of pyrogens in extracts was markedly reduced. Pyrogens could also be detected in extracts from an angiographic catheter after it had been handled with latex gloves, whereas an unused catheter was free from pyrogens. The incidence of febrile reactions in our catheterization laboratory has been markedly reduced from 11.6% to 0.6% when rinsing the latex gloves prior to the catheterization was included in our routine procedure. So far the absence of pyrogens in surgeons' sterile gloves has not been demanded. Our observations indicate that such a requirement may be justified.

Effect of Ethylene Oxide on the Tapping of Hevea brasiliensis

IN recent years the importance of bacteria in limiting the effective yield of polyisoprene from Hevea brasiliensis has been described1. Further, the highly desirable stability and very low content of volatile fatty acids of sterile latex have been fully established2. Up to 1960, the apparatus for the extraction of sterile latex was costly, but recently I have used simple polythene ‘hoods’ to enclose the tapping panel, so that antibacterial atmospheres could be maintained during tapping.