Edlich Richard F, Wind Tyler C, Hill Lisa G, Thacker John G, McGregor Walter
Plastic Surgery Research Program, University of Virginia Health System, Charlottesville, Virginia, USA.
J Long Term Eff Med Implants. 2003;13(1):1-10. doi: 10.1615/jlongtermeffmedimplants.v13.i1.10.
Extensive clinical investigations have demonstrated that double-gloves and blunt-tipped surgical needles dramatically reduced the risk of accidental injuries during surgery. During the last decade, double-glove hole puncture indication systems have been developed that reduce the clinical risk of accidental needlestick injuries as well as detect the presence of glove hole puncture in the presence of fluids. When the outer glove is punctured, the colored underglove becomes apparent through the translucent outer glove, necessitating glove removal, hand washing, and donning of another double-glove hole puncture Indicator system. This article presents the first biomechanical performance study that documents the puncture resistance of blunt surgical needles in latex and nonlatex single gloves and double-glove hole puncture indication systems. The technique for measuring glove puncture resistance simulates the standard test for material resistance to puncture outlined by the American Society for Testing and Materials. The maximum puncture resistance force was measured by the compression load cell and recorded in grams with a strip chart recorder. Ten puncture resistance measurements for the taper point needle, blunt taper point needle, and blunt needle were taken from five samples of the Biogel Indicator underglove, Biogel Super-Sensitive glove, Biogel glove, Biogel Skinsense N Universal underglove, and Biogel Skinsense Polyisoprene glove; and the Biogel, Biogel Super-Sensitive, and Biogel Skinsense Polyisoprene double-glove hole puncture indication systems. The magnitude of puncture resistance forces recorded was influenced by several factors: glove material, number of glove layers, and type of surgical needle. For each type of curved surgical needle,the resistance to needle penetration by the nonlatex gloves was significantly greater than those encountered by the latex glove materials. The resistance to needle puncture of all three double-glove systems was significantly greater than that of either the nonlatex or latex underglove or outer glove. The taper point needle encountered the lowest puncture resistance forces in the five single gloves and the three double-glove systems. Blunting the sharp end of the taper point needle markedly increased its resistance to glove puncture in the five single gloves and five double-glove systems. The blunt-point surgical needle elicited the greatest needle penetration force in all of the single and double-glove systems.
广泛的临床研究表明,双层手套和钝头手术针可显著降低手术期间意外伤害的风险。在过去十年中,已开发出双层手套破孔指示系统,该系统可降低意外针刺伤的临床风险,并能在有液体的情况下检测手套破孔的存在。当外层手套被刺破时,有颜色的内层手套会透过半透明的外层手套显现出来,这就需要摘除手套、洗手并重新戴上另一套双层手套破孔指示系统。本文介绍了第一项生物力学性能研究,该研究记录了钝头手术针在乳胶和非乳胶单层手套以及双层手套破孔指示系统中的抗穿刺性能。测量手套抗穿刺性的技术模拟了美国材料与试验协会概述的材料抗穿刺标准测试。最大抗穿刺力由压缩测力传感器测量,并用带状图表记录仪以克为单位记录。对锥形尖针、钝锥形尖针和钝针进行了十次抗穿刺力测量,测量对象来自Biogel指示内层手套、Biogel超灵敏手套、Biogel手套、Biogel Skinsense N通用内层手套和Biogel Skinsense聚异戊二烯手套的五个样本;以及Biogel、Biogel超灵敏和Biogel Skinsense聚异戊二烯双层手套破孔指示系统。记录的抗穿刺力大小受几个因素影响:手套材料、手套层数和手术针类型。对于每种类型的弯形手术针,非乳胶手套对针穿透的阻力明显大于乳胶手套材料所遇到的阻力。所有三种双层手套系统的抗针刺力明显大于非乳胶或乳胶内层手套或外层手套。锥形尖针在五个单层手套和三个双层手套系统中遇到的抗穿刺力最低。将锥形尖针的尖锐末端钝圆,在五个单层手套和五个双层手套系统中显著增加了其对手套穿刺的阻力。钝头手术针在所有单层和双层手套系统中产生的针穿透力最大。