A scientific basis for choosing the technique of hair removal used prior to wound closure.
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Biomedical subjects
Publications and source records attributed to J G Neal.
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Holes in latex gloves can be reliably detected by commercially available electronic devices. The purpose of this study was to compare the performance of an electronic glove hole detection device using latex gloves to that of neoprene, vinyl, and nitrile latex-free gloves. The electronic hole detection device accurately detected holes in the latex gloves during the 2-h study. In contrast, the latex-free gloves were immediately conductive of electricity in the absence of holes. Consequently, electronic glove hole detection devices cannot be reliably used with latex-free gloves.
The purpose of this study was to compare the biomechanical performance of commercially available orthopedic gloves to that of a single surgical glove, as well as a double glove system. The orthopedic gloves were found to be thicker than the single surgical glove. This increased thickness of the orthopedic glove was associated with a greater resistance to glove puncture. The thickest orthopedic gloves also had reduced tactile sensitivity when compared to the single surgical glove. In addition, the glove donning forces and glove hydration rates varied considerably. These latter biomechanical performance parameters were not significantly related to glove thickness. The double glove systems tested in this study had similar performance characteristics in regard to many of the orthopedic gloves. The glove donning forces for the double glove systems were the lowest of the gloves tested. In addition, the double glove systems displayed the greatest resistance to glove hydration of the gloves tested. Their performance in the glove hydration tests and the force required to don the double glove systems were much more desirable than any of the orthopedic gloves. The results of this study indicate that the double glove systems may provide a desirable alternative to the use of the single orthopedic gloves.
The purpose of this study was to evaluate the performance of a new double glove hole detection system in the Emergency Department. First, the frequency of holes in both gloves of the double glove hole detection system was determined using a watertight test method. Second, the frequency of glove puncture was determined first by searching for the optical color change that occurs with the ingress of fluid in the double glove hole detection system. These same gloves were then removed and also checked for holes by the watertight test method. After removal from the package, no holes were detected in the two gloves of the system using the watertight test method. In 50 consecutive patients, there was no color change in the inner glove indicating glove puncture. When these same gloves were then tested with the watertight test method, 14 of the 50 double glove hole detection systems failed; all 14 outer gloves were punctured, and three of the inner gloves had holes without demonstrable injury to the skin. This double glove hole detection system is not a reliable system to detect holes in relatively dry clinical settings because the ingress of fluid by capillary action between the gloves is necessary to cause a color change in the inner glove that signals the presence of a hole.
The purpose of this study was to compare the biomechanical performance of new powder-free commercially available synthetic examination gloves to that of commercially available powder-free latex examination gloves. The synthetic gloves were significantly thinner than the latex gloves. Despite the decreased thickness, all three nitrile gloves, as well as the polyvinyl chloride glove, exhibited a greater resistance to glove puncture. The glove donning forces varied considerably among all gloves, and wet donning forces were greater than dry donning forces. Under dry conditions, the donning forces for the synthetic gloves were less than or equal to the forces for the latex gloves. Because of their increased puncture resistance and similar donning forces, synthetic gloves are a safe alternative to latex examination gloves.
The purpose of this study was to compare the resistance to viral penetration of powder-free synthetic examination gloves with powder-free latex examination gloves commonly used in hospitals. Because these gloves had no holes, this study examined viral penetration through a membrane. Using a standard bacteriophage penetration model, no bacteriophage penetration was detected through the membrane for any of the gloves tested. The new powder-free nitrile and polyvinyl chloride synthetic examination gloves provided comparable resistance to viral penetration as did the powder-free latex examination gloves.
Lacrimal canaliculitis is an infection of the lacrimal duct system. The classic features of lacrimal canaliculitis are mild to severe swelling of the canaliculus, mucopurulent discharge from the punctum, and a red, pouting punctum. Canaliculotomy with systemic or topical antibiotics is the most appropriate treatment for this disorder.
The influence of irrigation on bone cutting was determined by measuring the biomechanical performance of a bone cutting saw during irrigation with various solutions. Solutions of 0.9% saline and 10, 20, and 30% poloxamer-188 were used as the irrigant. A 10% solution of poloxamer-188 was judged to be the superior irrigant because it successfully maintained bone temperature at a controlled level without interfering with the rate of bone removal.
There are a wide variety of latex examination gloves now available for use by health care providers. A prospective randomized trial was completed to quantify the forces required to don a sample of seven cornstarch-lubricated gloves and 13 powder-free latex examination gloves. The data collected was analyzed by a 20 x 2 general factorial ANOVA, as well as two 1-way ANOVAs using a least significance difference post hoc test. Some powder-free gloves can be easily donned with dry or wet hands without tearing with forces comparable to those encountered with powdered gloves. With the advent of these powder-free examination gloves, powdered gloves can now be abandoned, protecting health professionals and patients from the dangers of absorbable dusting powders. Despite the dangers of the absorbable dusting powders and the Food and Drug Administration's requirement for labeling examination glove boxes, some manufacturers of powdered examination gloves do not appropriately label their boxes with a warning to the health professional and patient of the presence of powder.
The purpose of this study was to quantitate the effect of two monofilament synthetic absorbable sutures as well as a new monofilament synthetic absorbable suture, glycomer 631, in healing musculoaponeurotic incisions in rats. Because these three monofilament synthetic absorbable sutures provided secure closure of laparotomy incisions, their clinical use in laparotomy incisions is recommended.
Universal precautions mandate the use of examination and surgical gloves to protect the health professional from contact with the HIV virus. The purpose of this paper is to provide a review of the literature on the barrier properties of examination and surgical gloves measured by water leakage and viral penetration. The literature data indicate that glove composition, glove manufacturer, glove design (examination vs. surgical), and mechanical manipulation had considerable influence on glove performance when tested for leakage and viral penetration. In general, latex gloves were found to be superior to vinyl gloves as barriers to water leakage and viral penetration.
The purpose of this study was to determine whether glove hydration influenced bacteriophage penetration. Using an electronic glove hole-detection device, one brand of latex glove was identified that hydrated rapidly (3.25 min +/- 0.71 min), while another brand was selected that resisted hydration (120 min +/- 0 min). Using a standard bacteriophage penetration model, the amount of bacteriophage penetration in both the rapidly hydrating gloves and the gloves that resisted hydration was extremely small and did not differ significantly from each other.
The Food and Drug Administration (FDA) allows for labeling medical products that have reduced levels of total water-extractable latex protein. The standard test method of the American Society for Testing and Materials (ASTM) for analysis of latex protein in natural rubber and its products is a colorimetric assay with a precipitation step called the modified Lowry assay. In an analysis of latex external condom catheters, we have documented a significant difference in protein levels between two brands of external condoms. The modified Lowry assay is a significantly less specific method than is an immunochemical assay for measuring total water-extractable latex proteins. This nonspecificity of the modified Lowry assay makes it difficult to accurately identify medical products with extremely low levels of total water-extractable latex protein.
The SmartDrive console represents an important advance in small bone surgery because it monitors and coordinates the operation of its handpieces. The SmartDrive console has the following unique features: 1) a handpiece recognition system; 2) an instrument speed display; 3) a handpiece display and monitoring system; 4) a torque instrument control system; 5) a temperature monitoring system; 6) and an irrigation system. Mechanical performance studies have been undertaken that have validated the accuracy of the monitoring systems of the consoles. The consoles provided reliable recordings of the rotational speeds of their hi-speed drills. The MicroAire console automatically shuts off its power as the temperature increased to 110 degrees F (43 degrees C). In contrast, the Stryker Command 2 console has a limited monitoring system that can not alter the operation of the handpieces.
Holes in surgical gloves are considered to be an important source of transmission of pathogens between patient and surgeon. The purpose of this study was to determine if electrosurgery could alter the integrity of latex surgical gloves. The effects of electrosurgery on 11 brands of commercially available latex surgical gloves were tested through an in vitro study that simulated the conditions in the operating room. Glove hole puncture was encountered only with coagulation current operating at the highest setting. In addition, maximal surface area contact with the hemostat to the glove surface was required to produce glove puncture. The presence of powder and glove hydration were not significant determinants of glove hole puncture. On the basis of our study, we believe that all surgical gloves tested offered the surgeon adequate protection at commonly used levels of cutting and coagulation current, as long as no breach existed prior to the donning of gloves.
There are a wide variety of powder-free gloves that can now be used by surgeons. The purpose of this study was to quantify the forces required to don these powder-free surgical gloves. The lowest donning forces for wet hands was encountered with powder-free gloves coated with a hydrogel polymer. In addition, the hydrogel coated gloves exhibited the least increase in donning forces from dry hands to wet hands. While greater forces were encountered with the other commercially available powder-free gloves than the hydrogel coated gloves, they all could be safely donned on dry hands without tearing.
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