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Does exposure to polymethyl methacrylate bone cement increase the risk of surgical glove failure?
Nicholas Noye1,2, William Steadman1,2, Brent Whittaker1,2
1Department of Orthopaedics, Toowoomba Hospital, Darling Downs Health, Toowoomba, Queensland, Australia.
Introduction:
Surgical glove perforation has been linked to a double-fold increased risk of surgical site infection. Infection in the context of arthroplasty can have devastating consequences. In orthopaedics, use of polymethyl methacrylate (PMMA) bone cement is commonplace, and the impact on glove strength and perforation risk is not fully understood. This study aimed to examine the resistance to perforation and thickness of gloves following PMMA exposure, in accordance with the International Organization for Standardization (ISO) standard for glove integrity.
Methods:
Pairs of gloves were separated and randomly sorted into exposure and control groups. Twenty pairs of latex and 40 pairs of polyisoprene gloves were used. Exposure group glove cuffs were in contact with cement from a single surface of the glove for 13 min as cement cured. Force to perforation and glove thickness were tested in accordance with ISO guidelines.
Results:
Latex gloves were found to have a significantly increased force to perforation following PMMA exposure (10.26 Newtons (N) vs. 9.81 N, P = 0.048). Both polyisoprene under- and over-gloves were shown to have no significant change in strength to perforation post exposure (9.69 N vs. 9.83 N, P = 0.561, and 10.26 N vs. 10.65 N, P = 0.168, respectively). All groups were over the ISO standard minimum strength of 5 N.
Conclusions:
Exposure of latex and polyisoprene surgical gloves to PMMA bone cement does not appear to increase glove perforation risk and rather may improve natural rubber latex glove strength. This study supports the use of latex and polyisoprene surgical gloves in procedures that involve the handling of PMMA bone cement.
Insights
Polymethyl methacrylate (PMMA) bone cement exposure did not increase surgical glove perforation risk. Latex gloves showed improved strength, supporting their use with PMMA in orthopaedic procedures.
Area of Science:
- Orthopaedic Surgery
- Biomaterials Science
- Infection Control
Background:
- Surgical glove perforation elevates surgical site infection risk, particularly critical in arthroplasty.
- The interaction between polymethyl methacrylate (PMMA) bone cement and surgical glove integrity is not well-established.
- Understanding this interaction is crucial for preventing complications in orthopaedic procedures.
Purpose of the Study:
- To evaluate the impact of PMMA bone cement exposure on the perforation resistance and thickness of surgical gloves.
- To determine if PMMA exposure alters glove integrity beyond International Organization for Standardization (ISO) standards.
Main Methods:
- Latex and polyisoprene surgical gloves were exposed to curing PMMA bone cement for 13 minutes.
- Force to perforation and glove thickness were measured according to ISO guidelines.
- Control groups were tested without PMMA exposure for comparison.
Main Results:
- Latex gloves demonstrated a statistically significant increase in force to perforation after PMMA exposure (10.26 N vs. 9.81 N, P=0.048).
- Polyisoprene gloves (both under- and over-gloves) showed no significant change in perforation resistance post-exposure.
- All tested gloves maintained strength above the ISO standard minimum of 5 N.
Conclusions:
- Exposure to PMMA bone cement does not increase the risk of surgical glove perforation.
- PMMA exposure may enhance the mechanical strength of natural rubber latex gloves.
- Latex and polyisoprene surgical gloves are suitable for use in procedures involving PMMA bone cement.
