Unnoticed glove perforation during surgery: Single gloves versus double gloves

Abstract

Aim: The aim was to find out the incidence of glove perforation in surgeries using single and double gloves and to compare the various factors affecting glove perforation. Materials and Methods: This study was an open labeled, double arm, prospective study of 200 operations performed, 100 each with the surgical team wearing single and double gloves. Glove perforations were detected by hydroinsufflation (filling each glove with 1000cc of water). The number of glove perforations, site of glove perforations, duration of surgery, type of surgery and elective versus emergency surgery was compared. Results: A total 1031 gloves were used in our study, out of which perforations were detected in 9.12% (n = 94).It was most frequent in a single glove group (12.81%, 46/359), followed by the outer glove of the double glove (11.9%, 40/336) and was seen least in the inner glove of a double glove group (8/336, 2.38%). The incidence of perforation was highest for the operating surgeon (22-25%) when compared to the nurses and the assistants. About one-third of the surgeries had at least one member of the surgical team with perforation. Cases lasting longer than 90 min had a perforation rate of 46.66% when compared to 23% in cases lasting for a lesser duration. The incidence of perforation in elective surgeries was 28.66% as compared with 65% in emergency surgeries. The left index finger of the surgeon had the highest perforation rate, followed by the right thumb of the nurse. Laparotomies had a perforation rate of 65% when compared with 22% in other surgeries. Conclusions: Double gloving is better than using single gloves to prevent glove perforations and cross-infection. The surgeon who is the chief of the surgical team is most prone to have glove perforations. Surgeries lasting for a longer duration, laparotomies and emergency surgeries require extra care. Hence intra-operative glove change is recommended in such cases.