Re-usable low density polyethylene arm glove for puerperal intrauterine exploration.

OBJECTIVE To design a long arm glove that can be used within a puerperal uterus to prevent the health-care worker contracting HIV from an infected patient. The designed long arm glove should be cheap (affordable) and readily available in low resource centres and must have proven sterility assurance and tensile strength to confer protection for the health worker. DESIGN Prospective study. SETTING Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria from 1st December 2006 to 31st May, 2007. SUBJECTS Fifty medical students of both sexes were selected randomly and the average length from the styloid process to the mid upper-arm of each was measured and the average length was later determined. This was to determine the length of the low density polyethylene long arm gloves to be made from virgin polyethylene material. Consecutive cases of patients with retained placentae in the puerperium who were scheduled for manual removal of the placenta within the period. RESULTS Packs of low density polyethylene (LDPE) long arm gloves were made from virgin polyethylene material. When subjected to bacteriological analysis, three out of four glove packs were contaminated with Staphylococcus, Bacillus and Klebsiella species of bacteria. Gamma irradiation ranging from 28.133 to 83.35 kiloGray of gamma-irradiation (kGy) sterilised all the gloves as postirradiation glove specimens showed no bacterial contamination. However, at doses up to 50 kGy gamma irradiation caused "strengthening" of the polyethylene gloves. While at doses greater than 50 kGy, gamma irradiation caused "embrittlement" of the material. Thus, 50 kGy of gamma irradiation was found to be an ideal dose to strengthen and to sterilise the glove for usage. The sterilized gloves were found to be effective when used in consecutive cases of retained placenta in protecting the health care workers (HCW) from contamination by possibly HIV contaminated blood. CONCLUSION There is a risk of contracting HIV for the health-care worker while carrying out a procedure within the puerperal uterus. The low density polyethylene arm glove was designed to prevent this in low resource centres as it would be affordable, available, with proven sterility assurance and mechanical properties to confer protection for the health care worker.