Comparison of the Colonies Number of the Germs Formed Post Operation between the Utilization of Single, Double, and Orthopedic Gloves in Closed Fracture Operations More Than 2 Hours

Post-operative infection is still one of the most common nosocomial diseases that can cause great losses because it will increase the length of stay, use of drugs, and reduce the quality of life of the patients. The risk will increase if the number of colonies is> 105 bacteria per gram of tissue. Various ways have been done to reduce the number of bacteria in the operation area, including the use of surgical gloves. This study analyzed the comparison of the level of bacterial colonies that grew on the surface of single, double, and orthopedic surgical gloves in closed fracture management for more than 2 hours at Hasan Sadikin Hospital. The statistical analysis was done with p-value = 0.011 (<0.05), which means a significant difference in the number of germ colonies that grow between single, double, and orthopedic gloves. Double gloves and orthopedic gloves have a better ability to reduce bacterial colony growth. Meanwhile, there was no significant difference in the number of bacterial colonies formed between double gloves and orthopedics. Perforation is a factor affecting the number of germ colonies that formed. The use of double gloves and orthopedic gloves in closed fracture surgery for more than 2 hours shows the number of bacterial colonies formed is less than single gloves. There was a significant difference in the rate of perforation between standard surgical gloves and orthopedic gloves. Keywords: Bacteria colony, Single glove, Double glove, Orthopaedic glove, Perforation

TO COMPARE THE EFFECTIVENESS OF INTERMAXILLARY FIXATION USING ERICH ARCH BAR AND SCREWS IN MANDIBULAR FRACTURES – A RANDOMIZED CLINICAL STUDY.

Purpose: Intermaxillary xation (IMF) is an essential principle in the management of mandibular fractures; but with the recent advent of open reduction and internal xation (ORIF), the use of IMF is almost limited to intraoperative procedure only. This study aims to investigate and compare the effectiveness of Erich arch bar & intermaxillary xation (IMF) screws for the management of mandibular fractures. Materials And Method: A randomized prospective study was conducted on 20 patients with mandibular fracture, who were randomly allotted to two groups. Group A patients received intermaxillary xation using Erich arch bar and group B patients received IMF screws. The parameters assessed were time taken for application and removal of appliance, stability of occlusion, glove perforation, and pre-and post-operative plaque accumulation. Results: The mean time for placement of the Erich arch bar was 43.10 minutes as compared to 18.60 minutes with intermaxillary xation screws. Better occlusal stability was shown with an arch bar over IMF screws, and was statistically signicant. More glove tears or penetrations occurred during application in group A than Group B (p<0.01). Also, The Plaque Index assessment on removal of appliance showed a statistically signicant difference between the two groups; higher in the arch bar group. Conclusion: This study indicates that with acceptable occlusal stability, IMF screws technique is an effective and favourable alternative to Erich arch bars for temporary intermaxillary xation in mandibular fractures.

Surgical glove perforation during oral and maxillofacial surgical procedures: An experimental study

Propouse: surgical teams sometimes neglect surgical glove perforation. The aim of this study was to determine the prevalence of sterile glove perforation in maxillofacial surgical procedures. Methods: Two studies were performed. The first one evaluated 200 pairs of surgical gloves (50 in each group) used by first, second, and third-year residents (R1,R2,R3). In the second study, 150 pairs of surgical gloves were evaluated: 100 pairs were used by a third-year resident, including 50 pairs in oral surgery procedures and 50 pairs in trauma surgeries, and 50 pairs of unused gloves were tested as control. The gloves were examined for perforations by filling them with water and testing for leaks. Results: In the first study, 29 pairs (19.3%) were perforated. Of the 50 pairs of control gloves, 7 pairs (14%) showed perforations on either side. The thumb and index finger and the right-hand (dominant hand) gloves, were the most frequently perforated sites. In the second study, 6% of the gloves in the control group, 6% of the gloves used in oral surgeries, and 10% of the gloves used in trauma surgeries showed perforations. The index finger and thumb were the most affected sites. Conclusion: The perforation rate was higher for the dominant right hand. In both studies, the frequency of perforation of unused gloves was significant, indicating the need for better quality control of the gloves evaluated in this study.

Surgical hand preparation in an equine hospital: Comparison of general practice with a standardised protocol and characterisation of the methicillin-resistant Staphylococcus aureus recovered

Presurgical hand asepsis is part of the daily routine in veterinary medicine. Nevertheless, basic knowledge seems to be low, even among specialised veterinary surgeons. The major objectives of our study were to assess current habits for presurgical hand preparation (phase 1) among personnel in a veterinary hospital and their effectiveness in reducing bacteria from hands in comparison to a standardised protocol (phase 2). Assessment of individual habits focused on time for hand washing and disinfection, the amount of disinfectant used, and the usage of brushes. The standardised protocol defined hand washing for 1 min with liquid neutral soap without brushing and disinfection for 3 min. All participants (2 surgeons, 8 clinic members, 32 students) used Sterillium®. Total bacterial counts were determined before and after hand washing, after disinfection, and after surgery. Hands were immersed in 100 ml sterile sampling fluid for 1 min and samples were inoculated onto Columbia sheep blood agar using the spread-plate method. Bacterial colonies were manually counted. Glove perforation test was carried out at the end of the surgical procedure. Differences in the reduction of relative bacterial numbers between current habits and the standardised protocol were investigated using Mann-Whitney-Test. The relative increase in bacterial numbers as a function of operation time (≤60 min, >60 min) and glove perforation as well as the interaction of both was investigated by using ANOVA. Forty-six and 41 preparations were carried out during phase 1 and phase 2, respectively. Individual habits differed distinctly with regard to time (up to 8 min) and amount of disinfectant (up to 48 ml) used both between participants and between various applications of a respective participant. Comparison of current habits and the standardised protocol revealed that the duration of hand washing had no significant effect on reducing bacteria. Contrary, the reduction in bacterial numbers after disinfection by the standardised protocol was significantly higher (p<0.001) compared to routine every-day practice. With regard to disinfection efficacy, the standardised protocol completely eliminated individual effects. The mean reduction in phase 1 was 90.72% (LR = 3.23; right hand) and 89.97% (LR = 3.28; left hand) compared to 98.85% (LR = 3.29; right hand) and 98.92% (LR = 3.47; left hand) in phase 2. Eight participants (19%) carried MRSA (spa type t011, CC398) which is well established as a nosocomial pathogen in veterinary clinics. The isolates could further be assigned to a subpopulation which is particularly associated with equine clinics (mainly t011, ST398, gentamicin-resistant). Glove perforation occurred in 54% (surgeons) and 17% (assistants) of gloves, respectively, with a higher number in long-term invasive procedures. Overall, bacterial numbers on hands mainly increased over time, especially when glove perforation occurred. This was most distinct for glove perforations on the left hand and with longer operating times. Our results demonstrate that standardised protocols highly improve the efficacy of hand asepsis measures. Hence, guiding standardised protocols should be prerequisite to ensure state-of-the-art techniques which is essential for a successful infection control intervention.

THE INCIDENCE & PATTERN OF MICRO PERFORATION OF SURGICAL GLOVES AFTER SINGLE USE

Aim & Objectives: Concern about the transmission of infection from patients to healthcare workers & vice versa is increasing. According to occupational safety & health administration, USA guidelines, gloves must be worn whenever there is a reasonable likelihood of contact of body fluids of patients to health personnel's in order to prevent contamination. The aim of this study is to report the pattern & incidence perforation of surgical gloves after single-use during different dental &maxillofacial surgical procedures & also to compare the perforation rate in single & double gloving methods during different elective& emergency oral & surgical procedures.Material & Methods: This prospective study was done for six months in the department of oral &maxillofacialsurgery. All the gloves used during elective & emergency, minor & major surgical procedures were collected. Both visual & hydro insufflations techniques were used to check the gloves for perforation & parameters were recorded.Results: A total of 1000 gloves were recorded, used in emergency& elective procedures. The percentage of operating doctor, assistant nurses was recorded. 34.54% gloves used in IMF were perforated.22.14% gloves used in Trans alveolar extraction with burs and 13.33% sharp surgical instruments perforated gloves.Suture needles perforated 18% gloves and needle pricks during extraction perforated 12% gloves. The overall perforation rate in all surgical procedures mentioned above was 18.62%.The chi square value: 114.129 and p value < 0.001.Conclusions: Double gloving method reduces the risk of contamination from patient to operating staff & vice versa by reducing the inner glove perforation

At what point during total knee arthroplasty operations are gloves most frequently torn?

Purpose: The aim of this study was to determine the time points during a total knee arthroplasty operation when there is the greatest possibility of tearing a surgical glove and thus the stage of the operation at which there is the greatest risk of infection. Methods: The study included 300 total knee arthroplasty cases performed by 10 orthopedic surgeons. Using a chronometer during the operation, the upper layer of each surgical glove was removed and inflated with sterile saline at 10-min intervals. When a tear was determined, a record was made of the time it occurred, the stage of the operation, the finger that was torn, and the side (right or left hand). Results: The mean time of the glove perforation was 40.74 ± 10.69 min. Glove tears occurred at the rate of 28.9% ( n = 39) in the thumb, 63.7% ( n = 86) in the index finger, 2.2% ( n = 3) in the middle finger, and 5.2% ( n = 7) in the ring finger. The tears occurred after the femoral cut in 8.1% ( n = 11), after the tibial cut in 14.8% ( n = 20), at the stage of trial component reduction in 52.6% of cases ( n = 71), after placement of the prosthesis in 7.4% ( n = 10), and at the closure stage in 17% ( n = 23) ( p < 0.001). Conclusion: The fingers requiring the most care during total knee arthroplasty are the thumb and index finger. The stages of the operation with the greatest risk for glove tears are trial component reduction and wound closure. Changing gloves after these high-risk surgical stages would help to decrease the risk of periprosthetic infections. Level of Evidence: Level IV/Case series