Accommodating Latex Allergy Concerns in Surgical Settings

Management of latex hypersensitivity in the perioperative setting

Despite the introduction and use of latex-free gloves, natural rubber latex hypersensitivity is still an issue in hospital medicine both for patients and healthcare professionals. Clear understanding of the groups at risk as well as perioperative assessment and management is key to reducing complications and improving safety. In this literature review, we cover the perioperative management of patients with latex hypersensitivity, as well as the implications for healthcare professionals. We also review the cost analyses of latex hypersensitivity in the healthcare system and the evidence available.

Myelomeningocele: Medical Considerations and Stomatologic Aspects in the Dental Treatment

The aim was to analyze systemic and oral aspects of patients with myelomeningocele (MMC), relevant for their dental treatment. Dental treatment of these individuals requires the dentist's extensive knowledge and careful information to determine the dental treatment plan. Thirty participants aged 3 to 16 years were divided into 2 groups: study group (15 MMC individuals) and control group (15 healthy subjects). All patients were evaluated for: systemic conditions, use of medications, sequela of the underlying pathology, oral hygiene, diseases, convulsion, cerebrospinal fluid (CSF), allergy, behavior, learning, and mouth physical examination to assess the oral conditions. The study group presented: higher percentage using drugs (P < 0.05), 40% had convulsions (P < 0.05), 86.67% using CSF shunt, 53.33% presented latex allergies (P < 0.05), 53.33% were classified as anxious and with cognitive deficit (P < 0.05), showed more gingivitis (P < 0.05). The MMC individuals, in the majority, have shown cognitive impairment and anxious behavior, use of controlled drugs, convulsion, CSF shunt use, and latex allergy. The presence of periodontal tissue damage was higher in patients with MMC.

Perioperative latex hypersensitivity reactions: an integrative literature review

This article characterizes hypersensitivity reactions during anesthetic-surgical procedures. This integrative literature review was conducted in the LILACS, CINAHL, COCHRANE and MEDLINE databases including papers published from 1966 to September 2011. A total of 17 case reports, two prevalence studies and one cohort study were identified. Latex reactions were mainly type III and the primary source of intraoperative reaction was latex gloves. The average time for clinical manifestation was 59.8 minutes after anesthetic induction; 44.4% of patients reported a reaction to latex at the pre-anesthetic evaluation. It was determined that the history of allergic reactions to latex obtained in the pre-anesthetic evaluation does not ensure the safety of patients if the staff is inattentive to the severity of the issue. There is also a tendency to initially attribute the anaphylactic event to the anesthetic drugs.

In vitro induction of polyploidy and chromatid exchanges by culture medium extracts of natural rubbers compounded with 2-mercaptobenzothiazole as a positive control candidate for genotoxicity tests

We tested extracts of custom-made natural rubber samples for cytotoxicity using V79 cells and for chromosome aberration (CA) induction using CHL cells in compliance with the Japanese guidelines for basic biological tests of medical materials and devices. The samples were formulated with a high level of 2-mercaptobenzothiazole (MBT) (A); a low level of MBT (B); or zinc dibutyldithiocarbamate (ZDBC) (C). In the CA test, MBT induced mainly polyploidy, including endoreduplication, and ZDBC induced structural CAs. In the cytotoxicity test, culture medium extracts of A, B, and C suppressed colony formation to 50% of the control value at 53.1%, 94.3%, and >100%, respectively. Culture medium extracts of sample A induced polyploidy and structural CAs in the absence of an exogenous metabolic activation system (S9 mix), but at lower concentrations in its presence, indicating the existence of other leachable promutagens. The extracts of sample B induced structural CAs at the highest concentration and only with S9 mix. Sample C was negative. The facts suggest that sample A may be a candidate for a positive control for genotoxicity tests. The high frequency of polyploidy induced by sample A was not predicted by MBT, suggesting the usefulness of the test for safety evaluation of medical devices. Numerical CAs induced by MBT and sample A are discussed.

Patient Safety: Latex Allergy

Reactions to latex rubber products are a growing problem. The danger of latex allergy has been noted for many years, but it has gained significantly more attention since the institution of so-called"universal precautions" following the identification of AIDS and other transmitted viral diseases. Recognition of the various latex reactions ranging from contact dermatitis to true latex allergy is required to prevent unnecessary morbidity and mortality among health-care workers and patients. Several approaches to the problem of latex allergy are reviewed and guidelines for minimizing exposure are recommended.

Latex sensitivity awareness in preoperative assessment

The role of the preoperative assessment practitioner (POAP) has evolved hugely to allow them to become more autonomous in decision-making, particularly in the design of local protocols and guidelines for preoperative assessment. Good practice guidelines are imperative to ensure that all requirements for the patient have been identified before the day of surgery, which minimises the risk of late cancellations.

Latex allergy and otorhinolaryngological surgery

Latex allergy in the otorhinolaryngology patient requires forward planning and coordination of management plans between the surgical, nursing and anaesthetic departments in order to ensure a safe outcome.