ENFEKSİYON KONTROLÜ İÇİN DİŞ HEKİMLİĞİNDE KULLANILAN ELDİVENLER
Özellikle cerrahi girişimler sırasında AIDS, hepatit gibi ölümle sonuçlanabilen hastalıkların bulaşma riski sebebiyle bütün sağlık alanlarında eldiven kullanımı hızlı bir şekilde artmıştır. Diş hekimliğinde de iyi bir çapraz enfeksiyon kontrolü için diş hekiminin hasta muayene ederken eldiven giymesi gerekmektedir. Hasta ağzındaki mikroorganizmaların direkt enfeksiyonundan hekimi korumak ya da hekimde bulunan enfeksiyondan hastayı korumak için kullanılan eldivenler, iyi bariyer özelliğine sahip olmalıdır. Bu amaç için lateks, vinil ve nitril eldivenler kullanılır ve diş hekiminin hastaya uygulanacak işleme uygun eldiven seçebilmesi için bu materyallerin dermatolojik etkilerini, kalitesini ve kimyasal yapısını bilmesi gerekir. Yapılan çalışmalarda lateks ve nitril eldivenlerin vinil eldivenlere göre daha iyi koruma sağladığı bildirilmektedir. Dolayısıyla düşük riskli ve kısa süreli operasyonlarda bariyer özelliği tartışmalı vinil eldivenlerin; patojen bakteriler içeren kan kontaminasyonlu yüksek riskli operasyonlarda ise lateks ve nitril eldivenlerin kullanımı daha uygundur.
Gloves Used In Dentistry For Infection Control
Glove use in the health care setting has risen dramatically, when AIDS and potential contact exposure to hepatitis strains and other blood-borne pathogens became a concern. Nowdays, successful cross-infection control dictates that the dentist should be gloved whilst treating patients. To protect the operator from direct infection by microorganisms present in the patient’s mouth, and the patient from infection present in the operator, glove must form an impermeable barrier to potential pathogens. Latex, vinyl and nitrile gloves are available for this purpose and dentists should know their dermatological effects, quality and chemical compatibility. According to this study, nitrile and latex gloves provide better barrier protection than vinyl gloves. The barrier protection afforded by vinyl gloves is compromised so it is an appropriate barrier for low-risk procedures of short duration, nitrile or latex should be the glove of choice for high-risk situations, including exposure to blood-borne pathogens.
___
- 1. Rego A, Roley L. In-use barrier integrity of
gloves: Latex and nitrile superior to vinyl. Am
J Infect Control 1999; 27:405-410.
- 2. Korniewicz DM, El-Masri M, Broyles JM,
Martin CD, O'connell KP. Performance of
latex and nonlatex medical examination gloves
during simulated use. Am J Infect Control
2002; 30:133-138.
- 3. Walsh DL, Schwerin MR, Kisielewski RW et al.
Abrasion resistance of medical glove materials. J Biomed Mater Res B Appl Biomater
2004; 15:81-87.
- 4. Ready MA, Schuster GS, Wilson JT, Haanes
CM. Effects of dental medicaments on examination glove permeability. J Pros Dent 1989;
61: 499-503.
- 5. Molinari J. Dental infection control at the year
2000. JADA 1999; 130:1291-1298
- 6. Korniewicz DM, Kirwin M, Cresci K,et al.
Barrier protection with examination gloves:
double versus single. Am J Infect Control
1994; 22:12-15.
- 7. Douglas A, Simon T, Goddard M. Barrier durability of latex and vinyl medical gloves in
clinical settings. Am Ind Hyg Assoc J 1997;
58:672-676.
- 8. Olsen RJ, Lynch P, Coyle MB et al. Examination gloves as barriers to hand contamination
in clinical practice. JAMA 1993; 21:350-353.
- 9. Shulman ER, Brehm WT. Dental clinical attire
and infection-control procedures. Patients'
attitudes. J Am Dent Assoc 2001; 132:508-
516.
- 10. Korniewicz DM, Laughon BE, Cyr WH, Lytle
CD, Larson E. Leakage of virus through used
vinyl and latex examination gloves. J Clin Microbiol 1990; 28:787-788.
- 11. Özcan K, Sema C, Nermin Ç. Lateks allerjisi.
Solunum Hastalıkları 2006; 17:44-54.
- 12. Hamann CP, Nelson JR. Permeability of latex
and thermoplastic elastomer gloves to the bacteriophage phi X174. Am J Infect Control 1993;
21:289-96.
- 13. Hunt LW, Fransway AF, Reed CE et al. An
epidemic of occupational allergy to latex involving healthcare workers. J Occup Environ
Med 1995; 37:1204-1209.
- 14. American Society for Testing and Materials.
D5151, Standard test method for detection of
holes in medical gloves. Philadelphia: American Society for Testing and Materials; 1992.
- 15. Murray CA, Burke FJ, McHugh S. An assessment of the incidence of punctures in latex and
non-latex dental examination gloves in routine
clinical practice. Br Dent J 2001; 14;190:377-
380.
- 16. Oztan MD, Pekiner BD, Can A. Permeability of
latex gloves after exposure to 6 chemical
agents. Quintessence Int 2007; 38:537-543.
- 17. Cheung LK, Chow LK, Tsang MH, Tung LK.
An evaluation of complications following dental
extractions using either sterile or clean gloves.
Int J Oral Maxillofac Surg 2001;30: 550–554.
- 18. Kerr LN, Chaput MP, Cash LD et al. Assessment of the durability of medical examination
gloves. J Occup Environ Hyg 2004; 1:607-612.
- 19. Chadwick RG. The thermal insulating effects of
five dental gloves. J Oral Rehabil 2000; 27:341
-343.
- 20. Patel HB, Fleming GJ, Burke FJ. A preliminary
report on the incidence of pre-existing pinhole
defects in nitrile dental gloves. Br Dent J 2003;
8:509-512.
- 21. Tacir H, Kama DJ, Zortuk M, Eskimez S. Flexural properties of glass-fiber reinforced acrylic
resin polymers. Aust Dent J 2006; 51:52-56.