Innovative Surgical Gloves May Protect Against Punctures

- 1/13/2012 - Written by the Surgical Gloves team.

The dangers of being infected with harmful viruses such as HIV, Hepatitis B, and Hepatitis C are very real to health workers. Even though surgical gloves provide excellent barrier protection against blood borne pathogens, surgical gloves cannot prevent percutaneous injuries such as wounds from punctured needles. In a percutaneous case study conducted by Denise Cardo, M.D., 6-24 percent of surgical procedures had incidents of blood exposure to health care workers. In fact, there were over 800,000 cases of percutaneous accidents that were reported in the US in 1999 alone. Alarmingly, 22-31 percent of healthcare workers were infected with Hepatitis B from percutaneous exposure. The transmission rate for HIV is reported at 0.3%. Considering the constant exposure hazards the healthcare worker are in, it is not surprises to see these statistics. To get a glimpse of how needlestick exposures may occur, all we need to do is look inside an operating room. The surgical team, generally comprised of the surgeon, nurses, and anesthesiologist, is constantly passing sharp instruments to one another often times without looking. Even without factoring stress into the equation we can see that there is real probability of a blood exposure accidents happening.

Aren’t doctors sufficiently protected from blood borne pathogens by wearing medical gloves? It’s true that surgical gloves help prevent the transmission of harmful viruses, but all medical gloves are susceptible to punctures. A simple way to illustrate this is by filling a zip lock bag with water. The plastic does an excellent job of preventing water from escaping, but once you puncture the bag with a knife, the barrier is pointless and the water will spill out. Once a puncture occurs with surgical gloves, we lose the barrier protection that was afforded. In addition to punctures, we should remember that the FDA allows 1.5% of surgical gloves to pass through AQL limits imposed on medical glove manufacturers. For these reasons, it is not uncommon for surgeons to double glove in operating theaters; however, double gloving surgical gloves reduces the transmission rate of blood borne pathogens, but does not eliminate the threat.

This brings us to an innovative surgical glove called the G-VIR glove brought to us by Hutchinson Healthcare. G-VIR surgical gloves utilize three layers of barrier protection while utilizing disinfectant liquid agents in the inner-most layer. To be more specific, the antimicrobial agent used is biguanide and quaternary ammoniums. The beauty of this concept is that in clinical trials, the use of G-VIR gloves reduced the transmission of viruses by 81% in percutaneous incidents compared to when double gloving of traditional surgical gloves were used. This is the first surgical glove we know of that takes into consideration that accidents will occur in operating rooms and proactively protects surgeons and nurses against harmful viruses.

In 2008, the University of Leon in France conducted a clinical study of Hutchinson’s G-VIR surgical gloves in 100 procedures conducted by 6 surgeons which resulted in gathering data points of over 800 incidents of surgeons using G-VIR surgical gloves. The ultimate question was whether the G-VIR gloves provided a good feel and fit compared to traditional latex surgical gloves. Conclusions from this study resulted in finding that a vast majority of surgeons found the G-VIR surgical glove to be suitable for daily surgical procedures. Although the G-VIR surgical gloves’ donning ability were reported to be inferior compared to latex surgical gloves, the tactile feeling and dexterity affording was reported to be on par with double latex surgical gloves with less grip quality. In terms of integrity feel on the barrier, the six surgeons on average reported that the G-VIR surgical gloves were superior to latex surgical gloves. Most importantly, none of the 100 patients reported any side effects related to surgeons utilizing these new surgical gloves. In the end, the G-VIR surgical gloves make suitable substitutes to traditional latex surgical gloves.

The use of virus inhibiting surgical gloves like the G-VIR should not replace taking precautionary preventative measures in preventing blood exposure accidents from happening, but can act as effective proactive safety measures against blood borne pathogens. Although the G-VIR gloves have evident technological advantages, these surgical gloves come with a higher cost with University of Lyon reporting double gloving with latex surgical gloves cost roughly five times less. Over time, competition and economies of scale may help bring the price of G-VIR surgical gloves down making them more affordable. It will be interesting to see how Hutchinson Healthcare and other surgical glove manufacturers improve on this innovation.


References

  • - Caillota, Jean-Louis. First Clinical Study of a New Virus-Inhibiting Surgical Glove. Swiss Medical Weekly. 138:18-22. 2008.
  • - Cardo, Denise, M.D. A Case - Control Study of HIV Seroconversion in Health Care Workers after Percutaneous Exposure. The New England Journal of Medicine. November 20, 1997.
  • - CDC. Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis. Center for Disease Control and Prevention. June 29, 2001.
  • - Beltrami, Elise M. Risk and Management of Blood-Borne Infections in Health Care Workers. Clinical Microbiology Reviews. Vol. 13, no 3: 385-407. July 2000.