Latex versus nonlatex medical exami...

Latex versus nonlatex medical examination gloves

American Journal of Infection bridle April 2002

This studious mood determined the effects of glove stres exemplar of material, and manufacturer onward the barrier effectiveness of medical examination glove (1) Eleven brands, four materials (ie, nitrile, copolymer vinyl, latex), and five manufacturers were assessed. Five research assistants, blinded to the protoplast of glove material, tested violenceed and unstressed gloves for barrier effectiveness. A total of 5510 glove were standarded Unstressed gloves were tested through visual inspection and a water-leak example Stressed gloves were subjected to a stres protocol that included rubbing each glov hand with a washcloth in clean water following a specific series The same water-leak test used in succession the unstressed gloves then was used upon the stressed gloves.

Findings. Nitrile glove had the lowest failure rate (13%) Latex glove had a failure rate of 22% and vinyl and copolymer glove had the highest failure rate (82%) Adjusting for manufacturer and stres latex examination glove were three times more likely to fail than nitrile glove (odd ratio [OR] 1260; 95% confidence interval [CI], 137 to 750)

Clinical implications. In the perioperative setting where there is a high potential for front to blood and body fluids, the barrier effectiveness of glove is of critical importance. Consequently managers must consider carefully before selecting glove These findings prompt that manufacturer and material adumbration must be assessed vigorously during the selection process

validity of gum chewing on postoperative ileus

Journal of the American association of Surgeons, July 2002

Postoperative ileus, which is general after abdominal surgery, must be resolv before a patient can be discharged. (2) This investigation evaluated gum chewing as a convenient means of facilitating recovery from postoperative ileus after laparoscopic colectomy. Nineteen patients with colorectal cancer who underwent elective laparoscopic colectomy were assigned randomly to undivided of two groups. The experimental cluster consisted of 10 patients (ie, three women and seven men) They were allowed to chew gum three times by day from the first postoperative day until they began oral intake. The check group consisted of nine patients (ie, three women and six men) They received the same rehabilitation program as patients in the experimental assemblage but were not allowed to chew gum

Findings. All patients in the experimental assign places to tolerated gum chewing beginning in succession the first postoperative day. The first passage of flatus (ie, 21 days versus 32 days) and the first defecation (ie, 31 days versus 58 days) occurr significantly sooner for patients in the experimental clump than for those in the manage group (P = <.01). The long duration of stay was shorter, however not significantly shorter, for patients in the experimental clump (mean = 13.5 versus 145 days).

Clinical implications. In this research population, gum chewing appears to be an inexpensive, well-tolerated course of stimulating bowel motility and decreasing the time to discharge after laparoscopic bowel surgery This subject of attention should be replicated to provide further understanding of the part of gum chewing postoperatively. Perioperative encourages will need to include a discussion onward gum chewing safety (ie, reducing the potential for aspiration) in their preoperative teaching programs whenever this intervention is implemented.

Surgical mortality rates

Journal of the American society of Surgeons, August 2002

This retrospective thought used data from the national Medicare program to examine tends in surgical mortality. (3) Mortality rates for six cardiovascular conducts (ie, coronary artery bypass graft, aortic valve replacement, mitral valve replacement, abdominal aortic aneurysm repair, carotid endarterectomy, lower extremity bypass) and eight cancer actions (ie, colectomy, pancreatic resection, gastrectomy, esophagectomy, pulmonary lobectomy, pneumonectomy, nephrectomy, cystectomy) were examined. Data from 1994 to 1999 were used. Logistic regression archetypes adjusted for patient characteristics, comorbidities, and hospital book were used to assess the tends in the approximately 2.5 million patients who underwent these 14 high-risk transactions during the study period.

Findings. Mortality rates declined for the six cardiovascular measures significantly declining in coronary artery bypass graft (adjusted OR = 85; 95% CI 81 to 88) carotid endarterectomy (adjusted OR = 86; 95% C180 to 93) and mitral valve replacement (adjusted OR = 89; 95% C181 to 97) In contrast, mortality rates increased for colectomy; remained higher than 10% for pneumonectomy, gastrectomy, and pancreatic resection; and remained at least 15% for esophagectomy in every part the study period. Cardiovascular surgery risks appear to be decreasing with time while cancer surgery risks are not. Overall, high-risk surgery is not necessarily becoming safer.