The government officials and hospital administrators (fools who couldn’t be bothered to properly prepare for a pandemic but still demand that we listen to them because they know best) were suddenly begging the public to stop buying gloves and other PPE items and instead save them for medical personnel who would need them in the forthcoming battles. (Hopefully that little exercise also served as a warning to medical personnel to build their own personal supplies of PPE.)
The shortage of exam gloves prompted some to wonder whether it was possible to disinfect disposable gloves so that they could be reused safely to care for patients.
All medical personnel are taught from the earliest days of their training that disposable gloves are disposable for a reason. They are never to be reused. They are always to be changed after becoming soiled, between patients, and sometimes even between procedures on the same patient. It’s an issue that has actually never been an issue in the US. However, in third-world countries shortages of essential medical supplies are common, and getting creative about meeting needs is a way of life there. As we find ourselves living in the socialist paradise our betters are creating here, we may have to learn some new tricks to deal with glove shortages.
First off, all researchers agree on this issue: disposable gloves should never be reused if at all possible. But recognizing that the world is no longer an ideal place, here are what have been determined to be the best practices for disinfecting exam gloves and reusing them for patients.
Turkish researchers studied twelve different disinfecting agents (including soaps, sodium chloride, alcohol, and benzalkonium chloride) for eliminating Escherichia coli and Pseudomonas aeruginosa from exam gloves. The only effective options were chlorhexidine 4% liquid soap (chlorhexidine gluconate, Hibiscrub, Hibiclens) and povidone-iodine 7.5% liquid soap.[1] Betadine—10% povidone-iodine—did not eliminate the pathogens.[2]
A Johns-Hopkins study in 1991 found that an alcoholic chlorhexidine soap (‘Hibisol’) was effective in removing pathogens from the gloves. It was concluded that, if necessary, gloves could be reused between patients for non-sterile procedures provided that they were washed while on the hands with chlorhexidine soap.[3]
German researchers found that rubbing alcohol (60% solution) effectively disinfected latex gloves between patients up to ten times before the gloves started to deteriorate. Nitrile gloves began to deteriorate sooner. However, the higher concentrations of alcohol necessary to kill some pathogens also hasten the deterioration of the gloves, so the gloves should not be reused when dealing with patients with highly infectious diseases.[4]
Autoclaving (or using a pressure canner or instant pot to disinfect) disposable gloves resulted in a 30% perforation rate, according to a study in Sri Lanka.[5]
Dr. Joseph Alton suggests the following technique:
- While still on the hands, wash the gloves with soap and water to remove visible contamination.
- Remove the gloves and soak them in a solution of 1 part 3.5% plain bleach to 6 parts water for 10 minutes.
- For an additional layer of disinfection, then place the gloves in a pressure canner at 15 psi for 20 minutes and let dry in the canner.
- Unfortunately, as noted above, while increasing the disinfection this may also increase the perforation rate.[6]
In an ideal world, disposable gloves are never reprocessed or reused in any way. But when you’re living in an alternate reality, how do you make disposable gloves last—and work—as long as possible?
- Avoid as much waste as possible by educating personnel in the appropriate use of gloves in specific situations.
- Determine when gloves should be reprocessed and when they should be discarded (when visibly contaminated with blood or feces, or when in contact with a patient with a highly infectious disease).
- Ensure that gloves are put on and removed correctly so as not to contaminate inner and outer surfaces.
- Develop a clear system to show how many times a glove has been reprocessed and determine when to discard gloves.
- Inspect gloves for defects that arise due to reprocessing, including:
- Checking for visible cuts, holes, or openings
- Apparent discoloration
- Cracking or changes in shape or texture
- Lightly inflating gloves and then spraying with a mild, dilute soap solution to check for air leakage
In addition, consider double-gloving, if at all possible, when using reprocessed gloves. As a reminder, gloves don’t replace proper handwashing. Always wash thoroughly with soap and water before putting gloves on and after removing them.
Links to related posts:
References:
Robert
Brown, Reprocessing disposable gloves: Is it really an option?, Gloves
by Web, 3 April 2020,
https://glovesbyweb.com/blogs/news/reprocessing-disposable-gloves-is-it-really-an-option
(accessed 14 October 2021).
[1] P. Gotkas, et al., The effectiveness of various disinfection methods of the surface of gloved hands, Mikrobiyoloji Bulteni, July 1992, Vol 26 No 3, https://pubmed.ncbi.nlm.nih.gov/1528148/ (accessed 14 October 2021).
[2] P. Gotkas, et al., The effectiveness of various disinfection methods of the surface of gloved hands, Mikrobiyoloji Bulteni, July 1992, Vol 26 No 3, https://pubmed.ncbi.nlm.nih.gov/1528148/ (accessed 14 October 2021).
[3] S. Mehtar, et al., The effect of disinfectants on perforated gloves, Journal of Hospital Infection, July 1991, Vol 18 No 3, https://pubmed.ncbi.nlm.nih.gov/1680901/ (accessed 14 October 2021).
[4] F. A. Pitten, et al., The efficacy of repeated disinfection of disposable gloves during usage, Zentralblatt fur Hygiene und Umweltmedizin, February 1999, https://pubmed.ncbi.nlm.nih.gov/10084208/ (accessed 14 October 2021).
[5] P. C. Gunasekera, et al., Glove failure: an occupational hazard of surgeons in a developing country, Journal of the Royal College of Surgeons of Edinburgh, April 1997, Vol 42 No 2, https://pubmed.ncbi.nlm.nih.gov/9114678/ (accessed 14 October 2021).
[6] Joseph Alton, All About Medical Gloves, Survival Medicine, 10 July 2021, https://www.doomandbloom.net/all-about-medical-gloves/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+drBonesAndNurseAmysdoomAndBloomtmShow+%28.........DR+BONES+and+NURSE+AMY%27S+..........Doom+and+Bloom%28tm%29+Show%29 (accessed 14 October 2021).
20 october 2021
This is an interesting article, makes one think. I was always under the impression that if worst came to worse, reusing disposable items would have to be cleaned the best one can. It would be better than nothing at all. When I was a kid, I'm old :-), syringes and such was reuseable by sterilizing the best they could. Now days it seems if we have "virus/diseases/illnesses that can't be sterilized it seems. Thank you for the "rethinking" of health care products.
ReplyDeletereminds me of an incident back in the early dayz of the post Soviet collapse - modern West med supplies were shipped in for a disaster - the hospital scullery maids that cleaned the old fashion IV glass bottles were given poly disposible bags >>> plenty of head shaking mysteries that day
ReplyDeleteJennifer why not use Rubbermaid dish washing gloves? The gloves are to protect the user from contamination. The wounds we will be treating are already dirty by their nature. We cannot make that wound sterile, just surgically clean. Soap and sterile saline goes a LONG way in that task.
ReplyDeleteWhen I started out in medicine, we had reusable surgical gloves. They were basically Rubbermaid.
We are not doing sterile procedures but advanced civil war medicine aka ditch medicine. Better handwashing and medical isolation are advantages we have if we use them.
As noted above, re-using gloves is far from ideal. We don't want to re-use, so we have hundreds of pairs, including some sterile surgical, so that we do not have to. (If the collapse outlasts our glove supply, we are going to quit, pick up our marbles, and go home.) We might be able to spare a pair to someone else, but that person is going to need to take good care of them. So having information such as this can be useful even among the well-prepped.
DeleteI use dish washing gloves all the time in the kitchen, but I've never had a pair that actually fit my hands. I can't imagine trying to stitch someone up wearing dish washing gloves. That would be a nightmare for both parties.
Adhering to basic hygiene practices will save countless lives. But I'm not planning on others doing that. Even after all the pandemic nonsense, people still refuse to stay home when they are sick.
Jennifer, I don't think quit is a word in your vocabulary. You and I will do anything required to protect our families and trusted friends.
DeleteI can instrument tie wearing ill-fitting Rubbermaid gloves. So can you. Frankly most of our care will require little suturing. Securing a gross flap as to allow daily washings and retain anatomical healing is my plans.
Most surface wounds are infection issues and its generally a bad idea to suture them closed. Healing by bleeding control, washing and moist dressings for secondary intention healing is what most of the non-plastic surgery world does.
Boiled linen bandages are reusable as you and I cannot take out a bag of disposable trash every shift caring for a patient like we do in my hospital. During COVID while the daily delivery trucks were questionable, we had several semi-truck trailers of supplies in our parking lot. They were at best with NO Elective surgeries a few weeks worth.
We see eye to eye about the troubles hygiene stupid people will inflict on our little tribe. Thus, the medical isolation suggestion.
You have persuaded me. I shall acquire some more Rubbermaid gloves.
Delete"Hygiene stupid"--I love it.
PS Rubbermaid gloves are easy to wash up and line dry for next time. Just keep them out of the sunshine as UV eats all forms of glove rubber, even nitrile.
ReplyDeleteI DO however recommend sunshine for basic decontamination after you wash your bed lines and such.
A large pot and boiling linens work well especially for bedbugs and lice. Both of which I expect far more of as basic sanitation to fail.
I am sure we'll see a resurgence in all kinds of deadly diseases, and I am just as sure that bedbugs, lice, and scabies will make many of those who don't succumb to the former wish they had.
Delete