Starch peritonitis and its prevention

J. J. Sternlieb, D. C. McIlrath, J. A. van Heerden and E. G. Harrison Jr

Commercially available surgical gloves contain a derivative of cornstarch and peritonitis induced by particles of starch shed from gloves can be a serious complication of abdominal surgery. Five documented and two suspected cases of this condition are known to have occurred at this institution during a recent 12-month period, when 4,965 intra-abdominal procedures were performed. Clinical features included fever, migratory abdominal pain, and ileus. Treatment with corticosteroids proved effective. Studies of the effectiveness of operating room precautions used to eliminate starch contamination indicated that these precautions do not eliminate the problem completely. Preliminary experience with the use of sodium bicarbonate as a substitute for cornstarch derivatives to "lubricate" surgical gloves has proved promising in eliminating the hazard of starch peritonitis.