Face mask vs. glasses - steamy issue!

Re: Face mask vs. glasses - steamy issue!

Mark Hedberg — Wed, 02 Oct 2013 12:59:39 GMT

[quote user="Martin Atkinson"]

[quote user="robloxley"]I do wonder why the opticians and ophthalmologists I've met still wear glasses...[/quote] Nice one rob, a rhetorical question if there ever was one but I will answer it anyway: because they value their eyes and one disaster is enough to ,put them off?!

[/quote]

Because then you're encouraged to buy glasses, with annual rechecks and new prescriptions. Laser surgery is a one time thing they don't get paid for. :)

Re: Face mask vs. glasses - steamy issue!

Martin Atkinson — Wed, 02 Oct 2013 11:28:03 GMT

Re: Face mask vs. glasses - steamy issue!

Jenny Smith — Wed, 02 Oct 2013 10:45:48 GMT

[quote user="Anthony Dennison"]

Yeah, there was a storyline with this subject in the last season of Grey's Anatomy.

[/quote]

Everything comes back to Grey's eventually :)

Re: Face mask vs. glasses - steamy issue!

Laurence Webb — Tue, 01 Oct 2013 22:54:35 GMT

[quote user="robloxley"]

[quote user="GrooveJet"]I second laser eye surgery![/quote]

I do wonder why the opticians and ophthalmologists I've met still wear glasses...

[/quote]"First do no harm"?

Now I'm 40, and my father has glaucoma I now need to be checked for glaucoma myself.

Glaucoma screening is free on the NHS but having had laser surgery my IOP is iatrogenically lowered (the thinner corneal stroma would bulge out under pressure). It gave my optician the chance to flog me some infra-red (I think) scanning of my retina.

I still love to get up in the morning and not need glasses so a good trade off for me!

Re: Face mask vs. glasses - steamy issue!

Rob Loxley — Tue, 01 Oct 2013 22:34:57 GMT

[quote user="GrooveJet"]I second laser eye surgery![/quote]

I do wonder why the opticians and ophthalmologists I've met still wear glasses...

Re: Face mask vs. glasses - steamy issue!

Miriam Lodewyks — Tue, 01 Oct 2013 21:51:17 GMT

Back to the OP: I second laser eye surgery!

Re: Face mask vs. glasses - steamy issue!

Dagmar Steele — Tue, 01 Oct 2013 20:04:03 GMT

The study was done on sterile individually wrapped gloves. And yes of course it is better than not wearing any gloves. It just shows that you still should wash your hands before you put them on and that you shouldn't feel to save with them.

Re: Face mask vs. glasses - steamy issue!

Rob Davis — Tue, 01 Oct 2013 19:47:29 GMT

[quote user="Dagmar Steele"]

just a short remark on gloves, studies have shown that a huge percentage (I think I remember something around 30%) have holes when you take them out of the wrapping....

[/quote]

I would suspect this varies enormously with the quality of the gloves you are buying. Certainly we have tried cheaper non-sterile gloves which end up being a false economy as so many disintegrate when you try to put them on.

Even if there is a tiny hole in your sterile gloves, this still means that the vast majority of your skin (and particularly your fingernails) are covered by a sterile impervious barrier - this still has to be considerably better than wearing no gloves at all doesn't it?

Re: Face mask vs. glasses - steamy issue!

Anthony Dennison — Tue, 01 Oct 2013 17:48:43 GMT

[quote user="Dagmar Steele"]

just a short remark on gloves, studies have shown that a huge percentage (I think I remember something around 30%) have holes when you take them out of the wrapping....

[/quote]

Yeah, there was a storyline with this subject in the last season of Grey's Anatomy.

Re: Face mask vs. glasses - steamy issue!

Dagmar Steele — Tue, 01 Oct 2013 17:26:43 GMT

just a short remark on gloves, studies have shown that a huge percentage (I think I remember something around 30%) have holes when you take them out of the wrapping....

Re: Face mask vs. glasses - steamy issue!

Michael Woodhouse — Tue, 01 Oct 2013 17:06:40 GMT

[quote user="Gillian Mostyn"]Michael - if you puncture your gloves do you stop, re-scrub and re-glove?[/quote]

I used to cut and puncture them regularly but don't seem to do so now. Only if doing otho stuff.

If I clean rip the glove early into the op I will just change gloves. If it has become obvious I have a leak and blood inside the glove then I re-scrub.

I suppose even though I wear blue nitrile gloves when doing any farm work (they go on with my wellies) there is greater risk of contamination of my hands versus my smallie counterparts. How the old vets 'got away' with trimming feet in the morning and doing a caeser after lunch with bare skin will never fail to amaze me.

Re: Face mask vs. glasses - steamy issue!

Gillian Mostyn — Tue, 01 Oct 2013 16:57:10 GMT

Very interesting paper - thank-you.

Many good points, but one that surprised me was when it says that antimicrobial use should be initiated within 30 mins of surgery, and not continued beyond 24hrs after surgery, to give maximum benefit and reduce risk of resistance.

Maybe that penicillinLA jab that the dinovets were using for all those years wasn't bad practice afterall.......

Re: Face mask vs. glasses - steamy issue!

Gillian Mostyn — Tue, 01 Oct 2013 16:49:55 GMT

[quote user="Rob Davis"]Stop and reglove, certainly, but why would you need to re-scrub?[/quote]

I seem to remember that once you've worn gloves for a while, with the resultant sweaty palms, then if you tear the glove then the contamination is worse than if you'd never worn them. Thus you need to rescrub.

Makes sense to me, but maybe I dreamt it...???

Re: Face mask vs. glasses - steamy issue!

Rob Watkins — Tue, 01 Oct 2013 15:57:05 GMT

The NHS have indeed started to resolve MRSA. They view the patient as the risk

So their focus since 2007 has been on reducing the bacterial count on the patients skin.

They absolutely view the patient as the hazard to their hospital.

So the next time the nurse is prepping up your patient...

Take a look at the toothbrush that they used to clean the clippers...

then ask them what dilution rate that pinkish-colured scrub solution is.

Finally, take a look at the nozzle of the alcohol spray bottle that they liberally aerate all around the theatre.

Re: Face mask vs. glasses - steamy issue!

Bob Russell — Tue, 01 Oct 2013 15:10:45 GMT

I know the red stars will be coming out to play but when I was training we were taught to glove and gown in the full knowledge that virtually nobody out in general practice were gloving up routinely in the hundreds of general practices up and down the country. Some did for ortho procedures, many did not.

Post-op infection in first opinion practice for most procedures was and still is very small.

I am no expert (perhaps in anything!) but my patients seem to get on fine. I am not an enthusiastic surgeon and happily get more expert vets to do procedures I am not confident in performing if I can.

I was under the impression that the MRSA disaster in the NHS is coming down at least in part because they have realised that the major source of the infection is not the surgeon but the patient. Now chlorhexidine washes for several days prior to elective surgery seem to be the norm.

Are gloves there to protect the surgeon as much or more than the patient? I await comments from those far more informed than I am!

Re: Face mask vs. glasses - steamy issue!

Rob Davis — Tue, 01 Oct 2013 14:50:35 GMT

[quote user="Gillian Mostyn"]Michael - if you puncture your gloves do you stop, re-scrub and re-glove?[/quote]

Stop and reglove, certainly, but why would you need to re-scrub?

Re: Face mask vs. glasses - steamy issue!

Gillian Mostyn — Tue, 01 Oct 2013 13:36:45 GMT

Michael - if you puncture your gloves do you stop, re-scrub and re-glove?

I hate gloves and am guilty of avoiding wearing them if possible. I always seem to puncture or rip them.....

Re: Face mask vs. glasses - steamy issue!

Rob Davis — Tue, 01 Oct 2013 13:03:14 GMT

[quote user="Michael Woodhouse"]psychotrophs[/quote]

Wow - they sound scary!

Re: Face mask vs. glasses - steamy issue!

Michael Woodhouse — Mon, 30 Sep 2013 23:21:06 GMT

Hell guys - even I wear glove for operating.

You have bacteria in your pores that I am lead to believe can move out to re-colonise the skin.

I would also say that a strain of bacteria that was hidden under your fingernail or deep in a skin pore is far more likely to be adapted to live on another mammal and cause an infection. Compare that to the dust organisms (psychotrophs) and they have little propensity to cause disease.

Only wear masks for dentals.

Only gown for ortho

I even wear gloves for large animal ops..........

Re: Face mask vs. glasses - steamy issue!

Martin Atkinson — Mon, 30 Sep 2013 19:14:37 GMT

[quote user="Bob Russell"]

I feel I should wear gloves routinely but don't! No obvious infection issues. Longer, more involved surgery or if I have hand injuries, out come the gloves!

[/quote] OK I wear gloves if I have a deep cut I may not be able to scrub properly and I think about it in orthopaedics because that ~1% wound infection rate will be worse if its in a fracture with an implant but most of the time the gloves get ripped on pins, screws and bone shards anyway so whats the point in that I ask myself? There's not much logic as far as I can see in wearing gloves because the op is longer, your hands are not going to get any more un-sterile after an hour than 5 minutes, but on second thoughts I guess that that 1% again becomes more likely to be a problem with tissue damage if its prolonged. Although by that point contamination by air is more likely to be your problem unless you've got sterile air in the op room and how many of us have that? Just thinking out loud rhetorically.

Re: Face mask vs. glasses - steamy issue!

Bob Russell — Mon, 30 Sep 2013 18:10:25 GMT

I feel I should wear gloves routinely but don't! No obvious infection issues. Longer, more involved surgery or if I have hand injuries, out come the gloves!

Re: Face mask vs. glasses - steamy issue!

Martin Atkinson — Mon, 30 Sep 2013 17:34:14 GMT

[quote user="mariette asselbergs"] I wished there was one for not wearing gloves too.......(I do wear gloves now but really feel bereft of good feeling what I am doing).[/quote] Here's one then: I never wear gloves and I get hardly any wound infections, I think I am a better and faster surgeon for having more 'feel' without gloves, and shorter exposure time + less trauma = less likely to get wound infection. Trust your scrubbing technique.

Re: Face mask vs. glasses - steamy issue!

mariette asselbergs — Sun, 29 Sep 2013 10:10:46 GMT

Ha thanks David, I hate masks and never wear them except over my mouth for dentals. I always feel a bit guilty when I see the younger ones conscientiously wearing them but now I have a (admittedly 2nd hand) evidence based excuse. I wished there was one for not wearing gloves too.......(I do wear gloves now but really feel bereft of good feeling what I am doing).

Mariette

Re: Face mask vs. glasses - steamy issue!

Kate Richardson — Sat, 28 Sep 2013 22:02:39 GMT

[quote user="David Mills"]

Masks in human medicine are only worn to protect the wearer from blood borne disease, and they have absolutely no influence on SSI rates. The paper ones become quickly soaked with moist breath and are therefore useless at preventing transfer from surgeon to patient. Also, the breath has to go somewhere - the mask merely redirects it, and not by much.

Solution: don't wear one.

[/quote]

+1 I wear glasses and only wear a mask for dentals for my benefit, not the patients.

Re: Face mask vs. glasses - steamy issue!

Martin Atkinson — Fri, 27 Sep 2013 16:55:12 GMT

[quote user="Rob Davis"]...looking like Adam Ant isn't all bad...[/quote] Careful, you are showing your age!