Influence of intraoperative closed glove exchange on glove contamination during clean soft tissue surgeries.

Abstract

To determine the influence of intraoperative glove exchange on glove contamination during clean soft tissue surgery. Prospective clinical study. Two hundred pairs of gloves and gowns from 50 clean soft tissue surgeries. Gloves and gown cuffs were cultured from the primary surgeon and first assistant using a standardized protocol. Cultures were taken from outer surface of both gown cuffs prior to surgery and after gloves were removed at the end of surgery; gloves were cultured prior to surgery, at end of surgery and after a new pair was donned after closed glove exchange. Cultures were evaluated for colony-forming units after 72 h of inoculation. Bacterial contamination was documented in 41 of the 50 surgeries (82%). The most common species cultured was Streptocococcus spp. There was no difference (p=.719) in the bacterial contamination rate of gown cuffs prior to surgery (10%; 20/200) compared to after surgery (9.5%; 19/200). The bacterial contamination rate for gloves was 10.5% (21/200) prior to surgery, 19.5% (39/196) after surgery, and 11% (22/200) after regloving. Gloves cultured following surgery were significantly more contaminated than gloves cultured preoperatively (p=.010) or gloves cultured following regloving (p=.018). Glove exchange did not increase bacterial contamination of gloves during the clean soft tissue surgeries tested here. The outside of the gown cuff does not seem to represent a major source of contamination during clean procedures. This study does not provide evidence to support a change in current practices for intraoperative closed glove exchange.