AW: AW: [HSF] Re: Post op antibiotics, double gloving

[Dr. Roberto Battellini]

It is very simple to think that washing more our hands the patients will be
more protected against infection, ...but what about the patient´s skin and
so on? 

-----Ursprüngliche Nachricht-----
Von: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] Im Auftrag von
Rwmfglycar at aol.com
Gesendet: Dienstag, 2. Oktober 2007 15:44
An: OpenHeart-L at lists.hsforum.com
Betreff: Re: AW: [HSF] Re: Post op antibiotics, double gloving

In a message dated 10/2/2007 10:10:19 A.M. Eastern Daylight Time,  
anianyanwu at hotmail.com writes:

Dear  Roberto

I also use 8/0 prolene for coronary bypass and have no problems  doing it 
with two pairs of gloves. One just has to adjust to reduced  sensitivity and

feedback in the way one does when performing minimally  invasive surgery.
Tactile 
feedback becomes a less critical part of the  technique and one learns to 
compensate with visual, indirect tactile and  auditory perceptions. If one
wishes 
to minimize the reduction in tactile  perception, then rather than use 
standard gloves, you could double glove with  "microsurgery" or
"supersensitive" 
gloves like the ophthalmic surgeons use to  handle 10/0 prolene and such
fine 
sutures. I used to use two supersensitive  gloves in training and found them

equivalent to a single standard glove. Now I  use two standard gloves and
find it 
satisfactory.

Do you not double  glove in a known Hepatitis C or HIV patient or you not
use 
8/0 prolene for  those cases? What about valve cases - why could we not 
double glove on those,  after all infection of our prosthesis is far more 
catastrophic than the now  relatively rare occurrence of infection in an
orthopaedic 
prosthesis?  

Ani

Dear Ani,
In Dec 1984 we did the first open heart operation on a patient with known  +

HIV status.  (The test had just been developed at Rockefeller). We  wore 
double gloves but this was not new to us; we had already been wearing
double 
gloves as a routine not for fear of acquiring infection from our patients
but to 
avoid passing our infections to the patients. It had been one of multiple  
measures adopted during an outbreak of staphylococcal infections some time
in the 
past. The epidemic was long since over but we continued the practice. At
the 
time there were hip replacement surgeons doing the same. 
We never tried to determine or guess which patient might be a danger to us.

Hepatitis C is much easier to acquire during an operation than HIV and we  
decided that the only rational way to avoid risk was to assume risk to be
always  
present.
As you say it was not difficult to get used to double gloves.
Bob
 








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