I just came back from an appointment to have sutures removed from the site of Mohs surgery on my scalp. It was a fairly big (probably a 1” circle) and deep wound which the surgeon had difficulty controlling the bleeding of and closing up. The Mohs proceedure was 17 days ago in San Antonio.

Today I noticed that the NP here in Jerkwater, who removed the stitches first put on gloves, then moved a rolling magnifier lamp with her gloved hands, then opened the sterile packaged tool kit and removed the sutures. She commented that the wound was still partially open and pretty deep and said she was concerned about it not healing due to being infected. She went to another room, handling the doorknob, came back in and cultured the wound and applied antibiotic ointment to the wound with her gloved finger.

My question:

What is the purpose of wearing the gloves? Are they supposed to be sterile? Clean? If they are, it seems to me that touching doorknobs, ballpoint pens, lamps and such with the gloved hands before working on an open wound isn’t really a very good methodology. But I’m not a doctor.

I lost a friend to MRSA not too long after he had knee surgery. Consequently, I’m kind of more closely observing the anti-infection methodology when I get medical care. Some of the stuff I see worries me. Can any knowledgeable members comment on my concerns?

Gloves are meant for exactly what you think that they are meant for, to protect "you from them", AND "them from you". Touching door knobs, chewed on pens, and other detritus should not occur before poking around in your wound.

Although I'm not a medical professional, my mother was the head of Quality Assurance for a major hospital and I had to endure all manner of dinnertime medical discussion whilst growing up. What gets me are the nurses and nurses aides with disgustingly long fingernails. Absolute breeding grounds for bacteria that need to be abolished.

On a side note, watch the fools at your local deli counter. They will typically touch all manner of shit with their gloved hands before they start fondling your meat.

“On a side note, watch the fools at your local deli counter. They will typically touch all manner of shit with their gloved hands before they start fondling your meat.”

Nobody has fondled my meat in quite a while.

That said, I quit eating at the local Subway after witnessing the “sandwich artist” pushing the contents of the trash barrel down with his freshly gloved hand before making a sandwich for the guy ahead of me in line. Guess he didn’t want garbage to get on his skin.

quote:

Originally posted by Rev. A. J. Forsyth:
On a side note, watch the fools at your local deli counter. They will typically touch all manner of shit with their gloved hands before they start fondling your meat.

Every deli and sandwich shop I know of has a policy that the employees will reglove upon request.

If you're concerned, just ask them to put a new pair on.

Gloves are primarily for the protection of the user. For many years, it was SOP to double-glove.

It's not so much for your protection as it is for the doctor, nurse, or EMT.

That’s nice. I’m the one with the wound.

You're not the one who faces several dozen biohazards every day. Gloving up is protection for the healthcare worker. It may provide some additional protection for the patient, but be realistic; the doctor or nurse is not going to re-glove every time they need to move a light or pick up a tool.

The light is wiped down. The tools are sterilized.

The threat of bloodborne pathogens to the healthcare worker is the reason that they are wearing the gloves.

Make the necessary preparations before gloving up, maybe. Or, reglove and add the additional cost of another pair of gloves to my bill. It would be a lot cheaper and easier than treating an infection.

if you don't report it , on paper , you are part of the problem.

I did it once in the e.r. and three times in restaurants.
always finish your complaint with ,

"you can not fix it , if you don't know that is broke" most people are grateful

I saw a nurse on TV who specialized in infective diseases give this advice when visiting friends or family in the hospital --- Leave the flowers at home. Bring some Clorox Wipes. Wipe down the guard rails on the hospital bed, the phone (and the telephone wire), the TV remote, the table next to the bed, and any other surfaces near the patient. Not long after seeing that, I was hospitalized for a minor procedure. My wife noticed a few red drops that appeared to be blood on the telephone wire. We had the staff wipe everything down. Infections caught in hospitals are a huge problem.

quote:

Originally posted by arfmel:
Make the necessary preparations before gloving up, maybe. Or, reglove and add the additional cost of another pair of gloves to my bill. It would be a lot cheaper and easier than treating an infection.

I hope you don't complain about the cost of treatment / medical insurance.

There are some surfaces within a procedure area that are wiped down or sterilized after each patient and are considered OK to touch with gloves.

In the dental world, it would generally be things that are attached to the chair and will be used during the procedure. Drawers MIGHT be included depending on the particular set up and office protocol. I really doubt that doors are wiped down in any setting outside of an OR.

quote:

Originally posted by RHINOWSO:

quote:

Originally posted by arfmel:
Make the necessary preparations before gloving up, maybe. Or, reglove and add the additional cost of another pair of gloves to my bill. It would be a lot cheaper and easier than treating an infection.

I hope you don't complain about the cost of treatment / medical insurance.

Well, I pay $1644/month for health insurance for my wife and I, now that it’s “free”. But I’d gladly pay the NP’s office an extra $25 for a $2.00 pair of clean gloves.

And I’d be willing to bet $100 that the surfaces in question in that exam room haven’t been “wiped down” in the past week.

You will probably be fine as long as your immune system is working. Proper procedure was not followed in your case. I would nicely report the issue. MRSA is endemic in many hospitals and nursing homes. C diff is an even bigger problem.

Back in the dark ages when I was in dental school, we were shown a video called "If Saliva Were Red". Not kidding. It sounds hokey as hell, but they dyed a "patient's" saliva with red coloring and then showed the transfer of that material around the office by a person wearing gloves out of the operatory, others subsequently touching that surface, etc. It was actually a pretty effective demonstration of the importance of being mindful of where your hands are when gloved and not touching anything that could lead to cross contamination.

You realize that those gloves aren't sterile, right?

They sure as shit aren’t sterile, or even clean, after touching the various items she handled wearing them. I don’t think it’s out of line to expect some measure of effort at cleanliness on the part of someone treating an open wound. I realize you don’t agree.

quote:

Originally posted by sns3guppy:
For many years, it was SOP to double-glove.

Huh?

I've worked in healthcare for almost 35 years, in half a dozen states, 25+ different facilities, and seven different capacities. Never has it been "SOP to double-glove" in anywhere I've been.

Stick to flying.

quote:

hey sure as shit aren’t sterile, or even clean, after touching the various items she handled wearing them. I don’t think it’s out of line to expect some measure of effort at cleanliness on the part of someone treating an open wound. I realize you don’t agree.

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When you see this sort of thing it is natural to wonder whether she did a good job removing the sutures and whatever else she did. Did she give you a prescription for broad spectrum antibiotics? I can see doing a culture but it is almost always staph of some type. If it is not better soon, call the Mohs surgeon for advice.

quote:

Originally posted by Gustofer:


I've worked in healthcare for almost 35 years, in half a dozen states, 25+ different facilities, and seven different capacities. Never has it been "SOP to double-glove" in anywhere I've been.

Stick to flying.

When I was a firefighter/EMT, and ran on an ambulance, it was standard to double glove. I do a bit more than fly.