[MCOH-EH] #ExtMail# Re: guidance for hand dermatitis in operating room staff

[Deborah A. Pruim]

ReGina,
I would check with the manufacturer on the recommendation for surgical use on the liners.  I know that one of my nurses in the PACU (post anesthesia care unit) does use them with good success.  At this point I do not have any surgical nurses in this situation.
Debbie

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Patrick, ReGina
Sent: Friday, June 08, 2018 9:00 AM
To: MCOH/EH
Subject: Re: [MCOH-EH] #ExtMail# Re: guidance for hand dermatitis in operating room staff

Debbie, can the cotton liners be used in surgery?
We also have seen an increase of hand dermatitis on our nursing units and in the surgery area.  Symptoms are worse during the winter.  Each associate completes an injury report and are given a hand dermatitis prevention handout and a skin assessment tool.   Most have symptoms resolve with use of durapro cream( Stokoderm).  There have been 3 surgical associates that required evaluation at our WIC.  2 were treated with clobetasol.  They continue to have intermittent dermatitis but it does clear after 24 hours.  The other associate has the cream but symptoms are increased with longer cases. We trialed Biogel and affinity microtouch gloves. We are still looking for a solution for him. There is a white cotton sterile glove that can be used.  May try a glove alternative from Medline first. They have quite a few sterile glove options.

ReGina Patrick RN
Associate Health and Wellness
Human Resources
Lakeland Health
1234 Napier Avenue
Saint Joseph, Michigan 49085
Tele: 269-985-4516
Fax:   269-934-8079
rpatrick at lakelandhealth.org<mailto:rpatrick at lakelandhealth.org>






From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Deborah A. Pruim via MCOH-EH
Sent: Friday, June 08, 2018 9:47 AM
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Cc: Deborah A. Pruim <dpruim at lcmh.org<mailto:dpruim at lcmh.org>>
Subject: Re: [MCOH-EH] #ExtMail# Re: guidance for hand dermatitis in operating room staff

[https://lakelandregionalimage.blob.core.windows.net/externalimage/externalmessage.png]
There are a few companies that make them.  The cotton liners from Medline are a good choice.  (I do not own stock in Medliine! :))
Hope this helps,
Debbie

From: MCOH-EH [mailto:mcoh-eh-bounces+dpruim=lcmh.org at mylist.net] On Behalf Of Grubbs, Scott
Sent: Friday, June 08, 2018 8:38 AM
To: MCOH/EH
Subject: Re: [MCOH-EH] #ExtMail# Re: guidance for hand dermatitis in operating room staff

She tested negative for gloves and scrub components.  She does (eventually) clear when not scrubbing for several weeks/months. She responds nicely to a shot of steroid given by her dermatologist, but cannot do that frequently.   What glove liners have you found helpful?
Thanks
Scott

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Deborah A. Pruim via MCOH-EH
Sent: Friday, June 08, 2018 9:28 AM
To: MCOH/EH
Cc: Deborah A. Pruim
Subject: #ExtMail# Re: [MCOH-EH] guidance for hand dermatitis in operating room staff

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Is she allergic to the surgical scrub components?  Has her skin cleared up since she has not been scrubbing?  We have had nurses who were not allergic to gloves but had a high sensitivity.  There are glove liners available and they have worked well for these nurses.  Just a thought.
Deborah Pruim, RN, MSN, APN, CNS
Employee Health Services
Little Company of Mary Hospital
2800 W. 95th Street
Evergreen Park, IL  60805
Monday - Friday
6:30am-3pm
Phone:  708-229-5623
Fax:  708-229-6618
dpruim at lcmh.org<mailto:dpruim at lcmh.org>
[cid:image001.png at 01D2A32C.E73F4EA0]



From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Grubbs, Scott
Sent: Friday, June 08, 2018 8:15 AM
To: MCOH/EH (mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>)
Subject: [MCOH-EH] guidance for hand dermatitis in operating room staff

An nurse in our institution who has scrubbed (uneventfully) for surgical procedures for several decades developed bilateral hand dermatitis last fall with significant cracking and peeling of her hands.  Allergy testing by an allergist for all the scrub/glove components was negative.  She has been using a variety of agents (and hand cleansers) prescribed by the allergist and an dermatologist and her hand will eventually clear if she doesn't scrub.  She has been prohibited from scrubbing and has been accommodated thus far, but wants to scrub.  My understanding from what I can find in the nursing literature (limited) is that she should not be handling operative tools, etc when she has open cracks in her skin, even with double gloving.  Am I correct?  Is there any guidance about how to handle this?  She is near retirement, but not ready to retire yet.  Also, if there are suggestions for specific remedies, I would be happy to pass them on to her.

Scott Grubbs, MD
WorkWell Occupational Health
Bon Secours St. Francis Hospital System
Greenville, SC
864-675-4632

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