Perforation of Surgical Gloves during Lower Extremity Fracture Surgery and Hip Joint Replacement Surgery

Purpose To assess the frequencies and sites of surgical glove perforations in lower extremity fracture surgery and hip joint replacement (HJR) surgery. Additionally, we also studied the usefulness of an indicator system glove. Materials and Methods We assessed surgical glove perforations in 30 cases of lower extremity fracture surgery and 18 cases of HJR surgery conducted by one right handed 1st operator from April 2013 to July 2013. We assessed frequencies and sites of perforation in 152 gloves; 95 used in lower extremity fracture surgery and 57 used in HJR surgery. We studied the perforation rates and sites according to participants and operation types. Using the Biogel indicator system glove, which is well known as a fast indicator of glove perforation, we were also able to assess the time difference between operative participant detection of perforation and inspector nurse detection while observing in the operative field. Results There were 18 of 30 cases in lower extremity fracture surgeries and 12 of 18 cases in HJR surgeries which had more than one surgical glove perforation event. Of all 152 gloves used, perforation occurred in 15 of 57 gloves (26.3%) in HJR surgery and 23 of 95 gloves (24.2%) in lower extremity fracture surgery. Perforation occurred more frequently in operators than assistant doctors or scrub nurses. The most frequent perforation site was the second digit of the left hand. On average, the time difference between operative participant notice of perforation and inspector nurse notice of perforation was 20.6 seconds. Conclusion The perforation of surgical gloves happened in approximately one out of every four persons. Importantly, we noted a 37.0% prevalence of glove perforation in 1st operators. Considering that glove perforation is a critical factor responsible for intra-operative infection, surgeons must be conscious of the risk of surgical glove perforation and use double gloving regularly. Furthermore, indicator double gloving is recommended for fast detection of outer glove perforation.

[1]  T. Laine,et al.  Perforation von Handschuhen in der Gefäßchirurgie: ein Vergleich zwischen einfachen und doppelten Handschuhen , 2013 .

[2]  N. Frebourg,et al.  Surgical glove bacterial contamination and perforation during total hip arthroplasty implantation: when gloves should be changed. , 2012, Orthopaedics & traumatology, surgery & research : OTSR.

[3]  M. Yılmaz,et al.  Glove perforation time and frequency in total hip arthroplasty procedures. , 2012, Acta orthopaedica et traumatologica turcica.

[4]  M. Zwahlen,et al.  Surgical glove perforation and the risk of surgical site infection. , 2009, Archives of surgery.

[5]  Masahiko Ohashi,et al.  Unnoticed glove perforation during thoracoscopic and open thoracic surgery. , 2005, The Annals of thoracic surgery.

[6]  T. Laine,et al.  Glove perforation in orthopaedic and trauma surgery. A comparison between single, double indicator gloving and double gloving with two regular gloves. , 2004, The Journal of bone and joint surgery. British volume.

[7]  W. Yinusa,et al.  Incidence of glove failure during orthopedic operations and the protective effect of double gloves. , 2003, Journal of the National Medical Association.

[8]  T. Laine,et al.  How often does glove perforation occur in surgery? Comparison between single gloves and a double-gloving system. , 2001, American journal of surgery.

[9]  T. Laine,et al.  Glove perforation rate in vascular surgery--a comparison between single and double gloving. , 2001, VASA. Zeitschrift fur Gefasskrankheiten.

[10]  K. Bhattacharya,et al.  Electronic evaluation of the value of double gloving , 2000, The British journal of surgery.

[11]  F. Gottrup,et al.  Incidence of glove perforations in gastrointestinal surgery and the protective effect of double gloves: a prospective, randomised controlled study. , 2000, The European journal of surgery = Acta chirurgica.

[12]  P. Wurnig,et al.  Glove perforation rate in open lung surgery. , 1999, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[13]  P. Nicolai,et al.  Increased Awareness of Glover Perforation in Major Joint Replacement: A Prospective, Randomised Study of Regern Biogel Reveal Gloves , 1997 .

[14]  P. Nicolai,et al.  Increased awareness of glove perforation in major joint replacement. A prospective, randomised study of Regent Biogel Reveal gloves. , 1997, The Journal of bone and joint surgery. British volume.

[15]  S. L. Jensen,et al.  Double gloving as self protection in abdominal surgery. , 1997, The European journal of surgery = Acta chirurgica.

[16]  S. Marín-Bertolín,et al.  Does Double Gloving Protect Surgical Staff from Skin Contamination during Plastic Surgery? , 1977, Plastic and reconstructive surgery.

[17]  Brown Jn.  Surgeon protection: early recognition of glove perforation using a green under glove. , 1996 .

[18]  J. Duron,et al.  Efficacy of double gloving with a coloured inner pair for immediate detection of operative glove perforations. , 1996, The European journal of surgery = Acta chirurgica.

[19]  J. N. Brown.  Surgeon protection: early recognition of glove perforation using a green under glove. , 1996, Journal of the Royal College of Surgeons of Edinburgh.

[20]  J. Wright,et al.  Surgical glove punctures during cardiac operations. , 1993, The Annals of thoracic surgery.

[21]  P. Frileux,et al.  Surgical glove perforation , 1989, The British journal of surgery.

[22]  A. M. Peacock,et al.  Surgical glove perforation , 1988, The British journal of surgery.

[23]  A. M. Thompson,et al.  Does wearing two pairs of gloves protect operating theatre staff from skin contamination? , 1988, BMJ.