Abstract
ObjectiveTo determine whether use of colored indicator gloves affects perforation detection rate and to identify risk factors for glove perforation during veterinary orthopedic surgery.Study DesignProspective randomized controlled trial.Sample Population574 double pairs of gloves worn during 300 orthopedic surgical procedures (2,296 gloves).MethodsPrimary and assistant surgeons double‐gloved for all orthopedic surgical procedures. Type of inner glove (standard or colored indicator) was randomized for the first 360 double pairs of gloves worn by surgeons during 180 procedures. Perforations detected by surgeons were recorded and gloves changed if requested. For a further 120 procedures, indicator gloves were used exclusively. All gloves were leak‐tested after surgery to identify perforations. Association between potential risk factors and perforation was explored using multivariate logistical regression analysis.ResultsGlove perforations occurred during 43% of surgeries with a mean of 2.3 holes/surgery. Inner gloves were intact in 63% of glove pairs where an outer perforation occurred. Intraoperative perforation detection was improved when colored indicator gloves were worn (83% sensitivity) vs. standard gloves (34% sensitivity; P<.001). Independent risk factors for perforation were placement of plates and/or screws (P=.001; OR=2.4; 95% CI, 1.4–4.0), placement of an external skeletal fixator (P=.002; OR=7.0; 95% CI, 2.1–23.8), use of orthopedic wire (P=.011; OR=2.4; 95% CI, 1.2–4.7), and primary surgeon being board‐certified (P=.016; OR=1.9; 95% CI, 1.1–3.1).ConclusionIncreased surgeon recognition of glove perforations through use of colored indicator gloves enables prompt change of gloves if perforation occurs and may reduce potential contamination of the surgical site.
Highlights
When indicator gloves were worn as the inner glove, 54 double pairs of gloves contained 1 perforation (30%) and of these the perforation was detected during surgery in 45 (83%)
Our randomized controlled trial demonstrates that wearing colored indicator gloves as the inner pair during doublegloving increased the surgeon’s ability to detect glove perforations from 34–83%
The ability to detect holes quickly enables the surgeon to change their outer pair of gloves, which should hopefully reduce any potential contamination of the surgical site in the event that both pairs of gloves are perforated
Summary
To determine whether use of colored indicator gloves affects perforation detection rate and to identify risk factors for glove perforation during veterinary orthopedic surgery. Despite the high incidence of glove perforation in a veterinary setting, the detection of glove perforations by surgeons is relatively poor with a sensitivity of 7–31%.6,7 The higher of these detection rates is similar to that reported during human surgery (37%).[12] One method employed to increase the detection of perforations by surgeons during procedures is the wearing of colored indicator gloves as the inner pair when double-gloving.[13] Indicator gloves are manufactured from standard surgical glove materials but have the addition of a colored dye. The aims of this study were to investigate whether wearing inner colored indicator gloves would affect the perforation detection rate by surgeons and to determine the risk factors leading to an increased rate of glove perforation during veterinary orthopedic surgery
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