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August 1994

Invited Commentary

Arch Surg. 1994;129(8):828. doi:10.1001/archsurg.1994.01420320050009

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DR HUNT'S simple but elegant study showing starch particles and granulomas in archival breast reexcision pathological specimens and abundant starch particles in washings from wounds in which starch-dusted gloves have been used (and their absence in washings when starch-free gloves are used) has served to again remind us of the iatrogenic potential of glove starch. Although one might quibble whether the tissue changes seen in these breast reexcisions have any clinical significance, there is ample historical evidence that glove starch is capable of causing serious problems, particularly after operations involving serous surfaces. Indeed, this problem had received considerable notoriety during the late 1960s and early 1970s when a clustering of cases of florid, postoperative glove starch peritonitis was reported. The response to this seeming epidemic, beyond stimulating considerable malpractice litigation, was twofold: intense interest by glove manufacturers to produce starch-free gloves (many brands are now available) and recommendations to operating

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