Recognition of intraoperative surgical glove perforation: a comparison by surgical role and level of training

Ian Thomson, Nicole Krysa, Andrew McGuire, Steve Mann, Ian Thomson, Nicole Krysa, Andrew McGuire, Steve Mann

Abstract

Background: The aim of this study was to characterize the risk of glove perforation among surgical team members performing a typical set of trauma procedures, as well as to identify the rate at which these people recognize potential perforations.

Methods: Gloves used in orthopedic trauma room procedures were collected from all participating team members over 2 weeks and were subsequently examined for perforations. Perforation rates based on glove position, type, wearer and procedure were assessed.

Results: Perforations were found in 5.9% of gloves; 4.3% of the perforations were found in outer gloves and 1.6% in inner gloves. Among the outer gloves, 30.7% of the perforations were recognized by the wearer at the time of perforation; none of the inner glove perforations were recognized, even when they were associated with an accompanying outer glove perforation. Significantly more perforations were identified in the gloves of attending staff than in those of other team members. Attending staff experienced more perforations than other wearers, regardless of whether they were acting as the primary surgeon or as an assistant. Perforations were more common in open reduction internal fixation and amputation procedures. For open reduction internal fixation procedures, longer operative times were associated with more frequent glove perforations.

Conclusion: The rates of glove perforation are high in orthopedic trauma surgeries, and often these perforations are not recognized by the wearer. Attending staff are at an elevated risk of glove perforation. It is recommended that all members of the surgical team change both pairs of gloves whenever an outer glove perforation is observed.

Conflict of interest statement

Competing interests: None declared.

© 2022 CMA Impact Inc. or its licensors.

Figures

Fig. 1
Fig. 1
The association between outer and inner glove perforations.
Fig. 2
Fig. 2
Glove perforations by surgical team member role.
Fig. 3
Fig. 3
Glove perforations by type of glove worn.
Fig. 4
Fig. 4
Glove perforation by procedure type. I&D = irrigation and débridement; ORIF = open reduction internal fixation; PSIF = posterior spinal instrumented fusion; TKA = revision total knee arthroplasty.

References

    1. Gerberding JL, Littell C, Tarkington A, et al. . Risk of exposure of surgical personnel to patients’ blood during surgery at San Francisco General Hospital. N Engl J Med 1990;322:1788–93.
    1. Panlilio AL, Foy DR, Edwards JR, et al. . Blood contacts during surgical procedures. JAMA 1991;265:1533–7.
    1. Eckersley JRT, Williamson DM. Glove punctures in orthopaedic trauma unit. Injury 1990;21:177–8.
    1. Lakomkin N, Cruz AI, Fabricant PD, et al. . Glove perforation in orthopaedics: probability of tearing gloves during high-risk events in trauma surgery. J Orthop Trauma 2018;32:474–9.
    1. Harnoss JC, Peartecke LI, Heidecke CD, et al. . Concentration of bacteria passing through puncture holes in surgical gloves. Am J Infect Control 2010;38:154–8.
    1. Misteli H, Weber WP, Reck S, et al. . Surgical glove perforation and the risk of surgical site infection. Arch Surg 2009;144:553–8.
    1. Demicray E, Unay K, Bilgili MG, et al. . Glove perforation in hip and knee arthroplasty. J Orthop Sci 2010;15:790–4.
    1. Sanders R, Fortin P, Ross E, et al. . Outer gloves in orthopaedic procedures. Cloth compared with latex. J Bone Joint Surg Am 1990;72:914–7.
    1. Matta H, Thompson AM, Rainey JB. Does wearing two pairs of gloves protect operating theatre staff from skin contamination? BMJ 1988;297:597–8.
    1. Thanni LOA, Yinusa W. Incidence of glove failure during orthopedic operations and the protective effect of double gloves. J Natl Med Assoc 2003;95:1184–8.
    1. Thomas S, Agarwal M, Mehta G. Intraoperative glove perforation — single versus double gloving in protection against skin contamination. Postgrad Med J 2001;77:458–60.
    1. Partecke LI, Goerdt AM, Langer I, et al. . Incidence of microperforation for surgical gloves depends on duration of wear. Infect Control Hosp Epidemiol 2009;30:409–14.
    1. Carter AH, Casper DS, Parvizi J, et al. . A prospective analysis of glove perforation in primary and revision total hip and total knee arthroplasty. J Arthroplasty 2012;27:1271–5.
    1. Food and Drug Administration. Leakage test method for surgical and examination gloves. Med Dev Doc Instr Rep 1988;14:11.
    1. Guo YP, Wong PM, Li Y, et al. . Is double-gloving really protective? A comparison between the glove perforation rate among perioperative nurses with single and double gloves during surgery. Am J Surg 2012;204:210–5.
    1. Laine T, Aarnio P. How often does glove perforation occur in surgery? Comparison between single gloves and a double-gloving system. Am J Surg 2001;181:564–66.
    1. Martin-Bertolin S, Gonzales-Martinez R, Gimenez CN, et al. . Does double gloving protect surgical staff from skin contamination during plastic surgery? Plast Reconstr Surg 1997;99:956–60.
    1. Al-Maiyah M, Bajwa A, Finn P, et al. . Glove perforation and contamination in primary total hip arthroplasty. J Bone Joint Surg Br 2005;87:556–9.
    1. Kim K, Zhu M, Munro JT, et al. . Glove change to reduce the risk of surgical site infection or prosthetic joint infection in arthroplasty surgeries: a systematic review. ANZ J Surg 2019;89:1009–15.
    1. McCue SF, Berg EW, Saunders EA. Efficacy of double-gloving as a barrier to microbial contamination during total joint arthroplasty. J Bone Joint Surg Am 1981;63:811–3.
    1. Ward WG, Cooper JM, Lippert D, et al. . Glove and gown effects on intraoperative bacterial contamination. Ann Surg 2014;259:591–7.

Source: PubMed

3
Abonnieren