Granular cell reaction to surgical glove powder

The histopathologic features characteristic of the inflammatory response associated with starch powder used as a lubricant for surgical gloves were investigated by implanting starch granules into 3 separate sites on the right side of 8 male Wistar rats. On the opposite side, a sham-operated site and sites implanted with talc were used as controls. Two rats were killed at 1, 2, 3 & 4-week intervals and tissue from the implanted sites was assessed for distinctive features. It was found that a consistent feature of the starch-implanted sites was the presence of large histiocytes containing prominent PAS-positive, diastase-resistant inclusions. These cells were not found in the control sites and, thus, were considered characteristic of starch contamination in tissue, even in the absence of identifiable starch granules. A possible clinical case of reaction to starch, identified retrospectively, using these results is discussed.