Bacterial migration through punctured surgical gloves under real surgical conditions

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions.</p> <p>Methods</p> <p>An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag method was used to retrieve organisms from the inner glove, and thus-obtained bacteria were compared with micro-organisms detected by an intra-operative swab.</p> <p>Results</p> <p>In 20 consecutive procedures, 194 gloves (98 outer gloves, 96 inner gloves) were examined. The rate of micro-perforations of the outer surgical glove was 10% with a median wearing time of 100 minutes (range: 20-175 minutes). Perforations occurred in 81% on the non-dominant hand, with the index finger most frequently (25%) punctured. In six cases, bacterial migration could be demonstrated microbiologically. In 5% (5/98) of outer gloves and in 1% (1/96) of the inner gloves, bacterial migration through micro-perforations was observed. For gloves with detected micro-perforations (n = 10 outer layers), the calculated migration was 50% (n = 5). The minimum wearing time was 62 minutes, with a calculated median wearing time of 71 minutes.</p> <p>Conclusions</p> <p>This study confirms previous results that bacterial migration through unnoticed micro-perforations in surgical gloves does occur under real practical surgical conditions. Undetected perforation of surgical gloves occurs frequently. Bacterial migration from the patient through micro-perforations on the hand of surgeons was confirmed, limiting the protective barrier function of gloves if worn over longer periods.</p

The durability of examination gloves used on intensive care units

Background: The use of examination gloves is part of the standard precautions to prevent medical staff from transmission of infectious agents between patients. Gloves also protect the staff from infectious agents originating from patients. Adequate protection, however, depends on intact gloves. The risk of perforation of examination gloves is thought to correlate with duration of wearing, yet, only very few prospective studies have been performed on this issue. Methods: A total number of 1500 consecutively used pairs of examination gloves of two different brands and materials (latex and nitrile) were collected over a period of two months on two ICU’s. Used gloves were examined for micro perforations using the “water-proof-test” according to EN 455–1. Cox-regression for both glove types was used to estimate optimal changing intervals. Results: Only 26% of gloves were worn longer than 15 min. The total perforation rate was 10.3% with significant differences and deterioration of integrity of gloves between brands (

Proposal for assessment of the antimicrobial efficacy of undiluted medical honey: Using a standardized phase 2/step 2 in vitro stainless steel disc carrier test model

Abstract PurposeThe antimicrobial efficacy of medical honeys used for professional wound care was published previously. So far, all in vitro antimicrobial tests performed have been conducted using non-standardized methods and used diluted medical honey. A standardized, reproducible phase 2/step 2 in vitro disc carrier model is proposed allowing testing the antimicrobial efficacy of undiluted medical honey. MethodsUsing a standardized disc carrier model, the log10 Reduction Factor (RF) of undiluted medical honey was determined for MSSA, MRSA, VRE, Pseudomonas aeruginosa, and Candida albicans, with and without protein challenge. ResultsAn antimicrobial efficacy was observed after 1h. Without organic challenge, log10RF >5 within 24h was achieved for all tested microorganisms, except for Staphylococcus aureus (log10RF: 4.8/24h). Challenged with 10% bovine serum albumin, a similar pattern was observed at 24h. The most susceptible organism was C. albicans (log10RF of >3/5min). Over an exposure time of 48h, the tested medical honey's antimicrobial activity under protein challenge achieved log10RFs >6 for C. albicans and >7log10 for all tested bacteria. ConclusionsIt was demonstrated that the proposed standardized phase 2/step 2 in vitro stainless steel disc carrier test model is applicable for testing the antimicrobial activity of highly viscous and undiluted compounds such as medical honey. Undiluted medical honey exhibits a strong antimicrobial efficacy even under protein challenge after 1h, which increases to >6log10 for C. albicans, and >7log10 for Gr+ and Gr− bacteria