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      Antibacterial activity of a sterile antimicrobial polyisoprene surgical glove against transient flora following a 2-hours simulated use

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          Abstract

          Background

          A surgical glove will protect surgeons and patients only if the glove’s integrity remains intact. However, several studies have demonstrated that undetected micro-perforations of surgical gloves are common. Because of the possibility of surgical glove puncture, an antimicrobial surgical glove was developed. The aim of this laboratory based experimental study was to assess the antibacterial efficacy of the interior chlorhexidine-gluconate (CHG)-coat of an antimicrobial synthetic polyisoprene surgical glove by using a standardized microbiological challenge.

          Methods

          Sixteen healthy adult participants donned one antimicrobial surgical glove and one non-antimicrobial surgical glove randomly allocated to their dominant and non-dominant hand following a crossover design. During a 2-h wear time, participants performed standardized finger and hand movements. Thereafter, the interior surface of excised fingers of the removed gloves was challenged with 8.00 log 10 cfu/mL  S. aureus (ATCC 6538) or K. pneumoniae (ATCC 4352), respectively. The main outcome measure was the viable mean log 10 cfu counts of the two glove groups after 5 min contact with the interior glove’s surface.

          Results

          When comparing an antimicrobial glove against an untreated reference glove after 2-h simulated use wear-time, a mean reduction factor of 6.24 log 10 ( S. aureus) and 6.22 log 10 ( K. pneumoniae) was achieved after 5 min contact.

          Conclusion

          These results demonstrate that wearing antibacterial gloves on hands does not negatively impact their antibacterial activity after 2-h of wear. This may have a potential benefit for patient safety in case of glove puncture during surgical procedures.

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          Most cited references21

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          National Healthcare Safety Network (NHSN) Report, data summary for 2006 through 2007, issued November 2008.

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            Surgical glove perforation and the risk of surgical site infection.

            Clinically apparent surgical glove perforation increases the risk of surgical site infection (SSI). Prospective observational cohort study. University Hospital Basel, with an average of 28,000 surgical interventions per year. Consecutive series of 4147 surgical procedures performed in the Visceral Surgery, Vascular Surgery, and Traumatology divisions of the Department of General Surgery. The outcome of interest was SSI occurrence as assessed pursuant to the Centers of Disease Control and Prevention standards. The primary predictor variable was compromised asepsis due to glove perforation. The overall SSI rate was 4.5% (188 of 4147 procedures). Univariate logistic regression analysis showed a higher likelihood of SSI in procedures in which gloves were perforated compared with interventions with maintained asepsis (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.4-2.8; P < .001). However, multivariate logistic regression analyses showed that the increase in SSI risk with perforated gloves was different for procedures with vs those without surgical antimicrobial prophylaxis (test for effect modification, P = .005). Without antimicrobial prophylaxis, glove perforation entailed significantly higher odds of SSI compared with the reference group with no breach of asepsis (adjusted OR, 4.2; 95% CI, 1.7-10.8; P = .003). On the contrary, when surgical antimicrobial prophylaxis was applied, the likelihood of SSI was not significantly higher for operations in which gloves were punctured (adjusted OR, 1.3; 95% CI, 0.9-1.9; P = .26). Without surgical antimicrobial prophylaxis, glove perforation increases the risk of SSI.
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              Concentration of bacteria passing through puncture holes in surgical gloves.

              The reasons for gloving-up for surgery are to protect the surgical field from microorganisms on the surgeon's hands and protect the surgeon from the patient's microorganisms. This study measured the concentration of bacteria passing through glove punctures under surgical conditions. Double-layered surgical gloves were worn during visceral surgeries over a 4-month period. The study included 128 outer gloves and 122 inner gloves from 20 septic laparotomies. To measure bacterial passage though punctures, intraoperative swabs were made, yielding microorganisms that were compared with microorganisms retrieved from the inner glove layer using a modified Gaschen bag method. Depending on the duration of glove wear, the microperforation rate of the outer layer averaged 15%. Approximately 82% of the perforations went unnoticed by the surgical team. Some 86% of perforations occurred in the nondominant hand, with the index finger being the most frequently punctured location (36%). Bacterial passage from the surgical site through punctures was detected in 4.7% of the investigated gloves. Depending on the duration of wear, surgical gloves develop microperforations not immediately recognized by staff. During surgery, such perforations allow passage of bacteria from the surgical site through the punctures. Possible strategies for preventing passage of bacteria include strengthening of glove areas prone to punctures and strict glove changing every 90 minutes. 2010 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.
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                Author and article information

                Contributors
                johannes.leitgeb@meduniwien.ac.at
                rupert.schuster@meduniwien.ac.at
                bitnew.yee@ansell.com
                puifong.chee@ansell.com
                julian-camill.harnoss@med.uni-heidelberg.de
                peter.starzengruber@meduniwien.ac.at
                michaelschaeffer@vinzenz.de
                o.assadian@hud.ac.uk
                Journal
                BMC Surg
                BMC Surg
                BMC Surgery
                BioMed Central (London )
                1471-2482
                4 July 2015
                4 July 2015
                2015
                : 15
                : 81
                Affiliations
                [ ]Department for Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
                [ ]Science & Technology Innovation Centre, Ansell Shah Alam, 40000 Shah Alam, Selangor Malaysia
                [ ]Department of General, Visceral and Transplant Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 110, D-69120 Heidelberg, Germany
                [ ]Department for Hospital Hygiene, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
                [ ]Department for General, Visceral, and Thoracic Surgery, Marienhospital Stuttgart, Böheimstrasse 37, D-70199 Stuttgart, Germany
                [ ]Institute for Skin Integrity and Infection Prevention, School of Human & Health Sciences, R1/29 Ramsden Building, University of Huddersfield, Huddersfield, HD1 3DH UK
                Article
                58
                10.1186/s12893-015-0058-5
                4490737
                60863a33-24f2-4bcb-a482-ff5ffe51a1bb
                © Leitgeb et al. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 23 September 2013
                : 25 May 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Surgery
                antimicrobial,surgical glove,transient flora,antibacterial efficacy,suppression
                Surgery
                antimicrobial, surgical glove, transient flora, antibacterial efficacy, suppression

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