Glove Perforation Research Articles

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

PurposeTo 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 MethodsWe 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.ResultsThere 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.ConclusionThe 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.

Study of Nature of Glove Puncture Injury and its Occurrence in Orthopaedic Surgery

Background: In orthopedic practice glove punctures are very common entity. Integrity of gloves act as a barrier in protecting the operating team from various blood related infections. Breach in this integrity of gloves make the operating team susceptible to patient’s body fluid and hence increases the infection chances. In today’s world due to presence of conditions such as HIV, Hepatitis B and C, our study is pointing out the infection rate and factors that can lead an operating team vulnerable to such infections. Material & Methods: Gloves that were collected from respective orthopaedic procedures were subjected to the standardized water leak test. These gloves were evaluated for leakages and were compared to a control group of unused gloves from the same pack after each respective surgical procedure. Result: The perforation rate of gloves was found to be 12.6 (240/1856) with operative perforation rate of 45%. The gloves of the surgeon got perforated at a rate of 21.4% (120/560). The perforation rate of index finger and thumb were the found to be 57% and 22% respectively. The perforation rate of outer glove was 81.3% and the inner glove was 20.4%. Those surgeries lasting more than 100 minutes were related to a perforation rate of 67%. Conclusion: Double gloving techniques are preferred to delineate the chances of glove perforation related infections and also encouraged for prolonged procedures which will eventually lead to the decreased chances of exposure. Key words: Gloves; Puncture; Surgery

Study of Glove Perforation during Hip Replacement Arthroplasty: Its Frequency, Location, and Timing.

Objective. The aim of the study was to evaluate the location, timing, and frequency of glove perforation during hip replacement arthroplasty. Methods. Gloves worn by surgical team members in 19 primary hip replacement arthroplasties were assessed. The study was of a single gloving system. All the used gloves were collected at the end of the surgery and assessed visually and by using water inflation technique. Relevant data were collected at the time of surgery. Results. A total of one hundred and ninety-one surgical gloves were evaluated. Twenty-three glove perforations were noted in nineteen of the operations. Of these perforations 14 belonged to gloves worn by surgeon and first assistant (60.1%). Glove perforation in thumb, index finger, and palm was more common. More perforation occurred in the gloves worn in nondominant hand (52%) but was insignificant. Conclusion. Glove perforation in surgeries such as total hip arthroplasty is not uncommon. In this study of single gloving system glove perforation rate was 12.04%, whereas literature reports of glove perforation rate as low as 3.3% in elective orthopedic surgeries with double gloving system. As such emphasis should be given to wear double pair of gloves wherever this practice is uncommon.

Perforación de los guantes e infección de la herida de esternotomía en cirugía cardíaca con circulación extracorpórea

Background and objectivesSurgical glove puncture breaks the barrier between the surgeon hands and the patient sterile wound tissues. The purpose of this work was to evaluate the effect of glove perforation on contamination of the sternal wound and postoperative infectious complications. MethodsA prospective study included 139 patients undergoing open heart surgery through a median sternotomy and seven cardiac surgeons. Glove puncture frequency and localization as well as wound contamination were evaluated at the end of the operation. Short and medium-term follow up was carried out to detect surgical site infections. ResultsGlove perforation rate was 23% of the samples being more frequent in the index and thumb of the nondominant hand. The rate of contamination of the sternotomy wound was 7.91% being Staphylococcus epidermidis the most frequent microorganism. None of the patients with either glove punctures or wound contamination presented any surgical site infection. ConclusionsThere is no correlation between glove perforation and sternal wound contamination and postoperative infectious complications. Surgical site infection is a more complex problem than it seems and depends of many other factors.

Bone-Supported Arch Bars Are Associated With Comparable Outcomes to Erich Arch Bars in the Treatment of Mandibular Fractures With Intermaxillary Fixation

Titanium arch bars that are directly fixated to the maxilla and mandible with self-drilling locking screws combine features of Erich arch bars and bone-supported devices and present an alternative method of intermaxillary fixation (IMF) that possesses potential advantages over existing techniques. The objective of this study was to compare IMF using this device with Erich arch bars secured with circum-dental wires. A retrospective cohort study was performed of patients who were surgically treated for mandibular fractures from 2012 through 2013. The primary predictor variable was fixation technique, which was IMF using Erich arch bars secured with circum-dental wires (group I) or titanium arch bars fixated with maxillary and mandibular screws (group II). The outcome variables were complication rates, time necessary for device application and removal, glove perforation rate, and cost. Statistical analysis was performed with InStat (GraphPad, Inc, La Jolla, CA) using the Fisher, χ(2), or Mann-Whitney test, as appropriate. Twenty-five consecutive cases in group I and in group II were reviewed. There were 43 male patients (86%) and 7 female patients (14%) with a mean age of 28.4 years. Mean follow-up was 2.0 months. Overall complication rates for groups I and II were similar (16.0% vs 12.0%, respectively; P = 1.00). In group II, there were 3 instances of delayed wound healing at the sites of gingivobuccal incisions attributed to the close proximity of the arch bar eyelets. The time necessary for device application was faster in group II than in group I (42 vs 62 minutes, respectively; P = .02). Bone-supported arch bars may be a comparable alternative to Erich arch bars secured with circum-dental wires for IMF. Careful planning of transoral incisions in relation to locking screw eyelets may help minimize wound complications.

Evaluation of Two Different Methods of Arch Bar Application: A Comparative Prospective Study

To comparatively evaluate the efficacy of a pencil type wire twister and the normal wire twister in terms of various parameters during arch bars application. The study involved residents of the department enrolled in MDS course. Two study groups of 60 patients each were made by randomly selecting the patients from the outpatient department of Oral and Maxillofacial surgery who required arch bar application. Group A included the patients who underwent upper and lower arch bar application with the use of a pencil type twister and group B included patients who underwent arch bar application with a normal wire twister. All respondents were given a questionnaire after the completion of procedure involving the use of medical sharps. The paired samples t test was used for statistical analysis. Among group A, mean glove perforations, actual wire stick injuries, mean time taken to complete the procedure, mean wire breakage during the procedure was less than in group B. Comfort level of patients and Ease of operator while performing the procedure was more in group A than in group B. Frictional abrasion of the finger was not associated with the use of pencil type twister. Overall rating of the procedure was more in group A than group B. The use of pencil type wire twister outweighs normal wire twister in various ways. It increases the overall efficacy of the operator during the procedure.

Practice of skin protection and skin care among German surgeons and influence on the efficacy of surgical hand disinfection and surgical glove perforation.

BackgroundSurgical hand rub and healthy skin are basic requirements to prevent surgical site infections. Nevertheless, there is little knowledge about the current practice of skin protection and/or skin care products (SP/SC) using among surgeons as well as a lack of data pertaining to the influence of SP/SC on the antimicrobial efficacy of surgical hand rub.MethodsA 10 weeks-survey among German surgeons as well as an experimental crossover study involving 26 participants were conducted. The immediate and sustainable efficacy (IE/SE) of surgical hand rub and participants’ hand moisture were measured after an 8-day usage of SP/SC, as well as the influence on micro-perforations on surgical gloves.ResultsThe questionnaire was available to 16,000 German surgeons. Thereof, 1,771 surgeons accessed the questionnaire, representing a total participation rate of 11%. As 19% (n = 338) of questionnaires were incomplete, a total of 1,433 completed questionnaires were available for further analysis. More than 75% of the participants stated not to use any SP/SC, yet, almost 50% suffered from skin irritation or discomfort. Only 5% used SP/SC at the beginning of their shift. 10% refused to use SP/SC because of concerns that SP/SC may reduce the antimicrobial efficacy of surgical hand rub.After usage of SP/SC over 8-days, skin moisture was significantly higher (P < 0.001), whereas no significant influence on the antimicrobial efficacy of surgical hand rub was observed (IE: P = 0.135; SP: P = 0.681). Micro-perforations were detected in 8/52 surgical gloves (15%), with no statistical significant difference between SP/SC users (n = 2/26; 8%) and non-users (n = 6/26; 23%; P = 0.249).ConclusionsFollowing the results of this largest questionnaire base survey among German surgeons on skin care, there is a need to educate and inform surgeons on the correct application and the concept of SP/SC strategies. In the present study, the combination of selected SP/SC products and one alcohol-based hand rub formulation did not show a negative interaction with surgical hand rub or surgical glove perforation. However, it is advisable to ascertain the compatibility of SP/SC products with the used hand disinfectant prior to purchase.

Investigation of Incidence and Risk Factors for Surgical Glove Perforation in Small Animal Surgery

To identify incidence and risk factors for surgical glove perforation in small animal surgery. Observational cohort study. Surgical gloves (n = 2132) worn in 363 surgical procedures. All gloves worn by operative personnel were assessed for perforation at end-procedure using a water leak test. Putative risk factors were recorded by a surgical team member. Associations between risk factors and perforation were assessed using multivariable multi-level random-effects logistic regression models to control for hierarchical data structure. At least 1 glove perforation occurred in 26.2% of procedures. Identified risk factors for glove perforation included increased surgical duration (surgery >1 hour OR = 1.79, 95% CI = 1.12-2.86), performing orthopedic procedures (OR = 1.88; 95% CI = 1.23-2.88), any procedure using powered instruments (OR = 1.93; 95% CI = 1.21-3.09) or surgical wire (OR = 3.02; 95% CI = 1.50-6.05), use of polyisoprene as a glove material (OR = 1.59, 95% CI = 1.05-2.39), and operative role as primary surgeon (OR = 2.01; 95% CI = 1.35-2.98). The ability of the wearer to detect perforations intraoperatively was poor, with a sensitivity of 30.8%. There is a high incidence of unrecognized glove perforations in small animal surgery.

Gloves, extra gloves or special types of gloves for preventing percutaneous exposure injuries in healthcare personnel.

Healthcare workers are at risk of acquiring viral diseases such as hepatitis B, hepatitis C and HIV through exposure to contaminated blood and body fluids at work. Most often infection occurs when a healthcare worker inadvertently punctures the skin of their hand with a sharp implement that has been used in the treatment of an infected patient, thus bringing the patient's blood into contact with their own. Such occurrences are commonly known as percutaneous exposure incidents. To determine the benefits and harms of extra gloves for preventing percutaneous exposure incidents among healthcare workers versus no intervention or alternative interventions. We searched CENTRAL, MEDLINE, EMBASE, NHSEED, Science Citation Index Expanded, CINAHL, NIOSHTIC, CISDOC, PsycINFO and LILACS until 26 June 2013. Randomised controlled trials (RCTs) with healthcare workers as the majority of participants, extra gloves or special types of gloves as the intervention, and exposure to blood or bodily fluids as the outcome. Two authors independently assessed study eligibility and risk of bias, and extracted data. We performed meta-analyses for seven different comparisons. We found 34 RCTs that included 6890 person-operations as participating units and reported on 46 intervention-control group comparisons. We grouped interventions as follows: increased layers of standard gloves, gloves manufactured with special protective materials or thicker gloves, and gloves with puncture indicator systems. Indicator gloves show a coloured spot when they are perforated. Participants were surgeons in all studies and they used at least one pair of standard gloves as the control intervention. Twenty-seven studies also included other surgical staff (e.g. nurses). All but one study used perforations in gloves as an indication of exposure. The median control group rate was 18.5 perforations per 100 person-operations. Seven studies reported blood stains on the skin and two studies reported self reported needlestick injuries. Six studies reported dexterity as visual analogue scale scores for the comparison double versus single gloves, 13 studies reported outer glove perforations. We judged the included studies to have a moderate to high risk of bias.We found moderate-quality evidence that double gloves compared to single gloves reduce the risk of glove perforation (rate ratio (RR) 0.29, 95% confidence interval (CI) 0.23 to 0.37) and the risk of blood stains on the skin (RR 0.35, 95% CI 0.17 to 0.70). Two studies with a high risk of bias also reported the effect of double compared to single gloves on needlestick injuries (RR 0.58, 95% CI 0.21 to 1.62).We found low-quality evidence in one small study that the use of three gloves compared to two gloves reduces the risk of perforation further (RR 0.03, 95% CI 0.00 to 0.52). There was similar low-quality evidence that the use of one fabric glove over one normal glove reduces perforations compared to two normal gloves (RR 0.24, 95% CI 0.06 to 0.93). There was moderate-quality evidence that this effect was similar for the use of one special material glove between two normal material gloves. Thicker gloves did not perform better than thinner gloves.There was moderate to low-quality evidence in two studies that an indicator system does not reduce the total number of perforations during an operation even though it reduces the number of perforations per glove used.There was moderate-quality evidence that double gloves have a similar number of outer glove perforations as single gloves, indicating that there is no loss of dexterity with double gloves (RR 1.10, 95% CI 0.93 to 1.31). There is moderate-quality evidence that double gloving compared to single gloving during surgery reduces perforations and blood stains on the skin, indicating a decrease in percutaneous exposure incidents. There is low-quality evidence that triple gloving and the use of special gloves can further reduce the risk of glove perforations compared to double gloving with normal material gloves. The preventive effect of double gloves on percutaneous exposure incidents in surgery does not need further research. Further studies are needed to evaluate the effectiveness and cost-effectiveness of special material gloves and triple gloves, and of gloves in other occupational groups.

Comparison of Intermaxillary Fixation Screw Versus Eyelet Interdental Wiring for Intermaxillary Fixation in Minimally Displaced Mandibular Fracture: A Randomized Clinical Study

The aim of the present randomized study was to evaluate the efficacy of intermaxillary fixation screw (IMFS) versus eyelet interdental wiring for intermaxillary fixation (IMF) in minimally displaced mandibular fractures. A total of 50 patients with a minimally displaced mandibular fracture were enrolled, with 25 patients randomly selected for each group. In group I (study group, n = 25), the patients were treated using IMFS, and in group II (control group, n = 25), they received eyelet interdental wiring. Both techniques were assessed for the following parameters: time required for placement and removal of each type of IMF technique, time required for placement of IMF wires, postoperative occlusion, stability of the IMF wire, local anesthesia requirement during removal of each fixation type, oral hygiene status, glove perforation rate, and complications associated with both techniques. The collected data were analyzed using Student's unpaired t test or χ2 test. P < .05 was considered significant and the Statistical Package for Social Sciences software, version 10, was used for analysis. The average time required for placement in groups I and II was 17.56 and 35.08 minutes, respectively (P = .000). The time required for placement of the IMF wire in group I was 2.1 minutes and in group II was 6 minutes. The oral hygiene status was assessed, and the mean plaque index score for groups I and II was 1.44 and 2.12, respectively (P = .00). The glove perforation rate was much less in group I than in group II. Finally, the most common complication in both groups was mucosal growth. The results established the supremacy of IMFS compared with eyelet interdental wiring. Thus, we have concluded that IMFS, in the present scenario, is a safe and time-saving technique. IMFS is a cost-effective, straightforward, and viable alternative to cumbersome eyelet interdental and other wiring techniques for providing IMF, with satisfactory occlusion during closed reduction or intraoperative open reduction internal fixation of fractures. In addition, oral hygiene can be maintained, and the glove perforation rate was very low using IMFS. The relatively small sample size and limited follow-up period were the study limitations.

Unnoticed glove perforation during surgery: Single gloves versus double gloves

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.

Is the surgical knot tying technique associated with a risk for unnoticed glove perforation? An experimental study.

BackgroundThe issue of safety in the surgical procedure has recently been widely and openly discussed at the World Health Organization. The use of latex gloves is the current standard of protection during surgery, as they remain intact throughout the procedure. The present study was designed to evaluate the rate of glove perforation during a two-hand technique using polyester sutures in a controlled experimental study.MethodsHypothesis was that the gloves used during a two-hand technique using polyester suture suffer punctures. We used 150 pairs of gloves during the experiment. Each investigator performed 30 tests always using double gloving. They made five surgical knots on each test over a custom-made table specifically developed for the experiment. Ten tests were done at a time with a week- interval. The Control Group (CG) has 30 pairs of intact surgical gloves. The gloves were tested to impermeability by water filling and leaking was observed at three different times. Statistics relating to the perforation rate were analyzed using the chi-square test. A P value less than 0.05 was considered statistically significant.ResultsDuring the experiment there was no loss of gloves by drilling or inadvertent error in performing the impermeability test. No perforations were detected at any time during the impermeability test with the gloves used for sutures. Also, the CG presented no leakage of the liquid used for the test. There was no statistical difference between the groups underwent suture nor between them and the GC.ConclusionUnder the studied conditions, the authors’ hypotheses could not be proved. There was no damage to the surgical gloves during the entire experiment. The authors believe that the skin abrasions observed in the ulnar side of the little finger, constant throughout the experiment, must be caused by friction. We feel there is no risk of perforation of surgical gloves during a two-hand technique using polyester suture.

Suppression of Surgeons' Bacterial Hand Flora during Surgical Procedures with a New Antimicrobial Surgical Glove

Perforations of surgical gloves are common and increase with the duration of glove wear. Skin flora, re-grown after pre-operative disinfection of the hands, may contaminate a surgical site. An antimicrobial surgical glove with chlorhexidine on its inner surface has been developed. We hypothesized that by suppressing the re-growth of skin flora during the complete course of a surgical procedure, antimicrobial gloves may reduce the risk of surgical site contamination in the event of an intra-operative glove breach. We conducted a randomized, double-blind, single-center trial, to measure any differences in the bacterial skin populations of surgeons' hands during surgical procedures done with antimicrobial and non-antimicrobial surgical gloves [ISRCTN71391952]. In this study, 25 pairs of gloves were retrieved from 14 surgeons who donned them randomly on their dominant or non-dominant hand. The number of bacteria retrieved from glove fluid was measured and expressed as colony forming units (CFU)/mL. The median cfu/mL of antimicrobial gloves was 0.00 (LQ: 0.00 CFU/mL; UQ: 0.00 cfu/mL), with a mean log10 cfu/mL=0.02 (range: 0.00-0.30). The median CFU/mL of non-antimicrobial gloves was 54.00 (LQ: 3.00 cfu/mL; UQ: 100.00 cfu/mL) with a mean log10 CFU/mL=1.32 (range: 0.00-2.39). After a mean operating time of 112 min, the difference in the log10 CFU/mL was 1.30 (p<0.001). A new antimicrobial surgical glove suppressed surgeons' hand flora during operative procedures. In the event of a glove breach, the use of such a glove may have the potential to prevent bacterial contamination of a sterile surgical site, thereby decreasing the risk of surgical site infection (SSI) and increasing patient safety. Further clinical studies are needed to confirm this concept.

Surgical glove perforation among nurses in ophthalmic surgery: A case‐control study

Many of the ophthalmic surgical instruments are extremely fine and sharp. Due to the dim light environment required for ophthalmic surgical procedures, the passing of sharp instruments among surgeons and scrub nurses also poses a risk for glove perforations. A case-control study was performed to determine the number and site of perforations in the surgical gloves used by a group of scrub nurses during ophthalmic surgery. All six nurses working in an eye and refractive surgery centre in Hong Kong participated in the study. A total of 100 (50 pairs) used surgical gloves were collected following 50 ophthalmic surgeries. Fifty pairs of new surgical gloves were also collected. Every collected surgical glove underwent the water leak test. The surgical procedure perforation rate was 8%, and none of the perforations were detected by the scrub nurses. No perforations were found in any unused gloves. The findings indicate that glove perforations for scrub nurses during ophthalmic surgery do occur and mostly go unnoticed. Future studies should continue to explore factors contributing to surgical glove perforation.

Risk of Glove Perforation With Arthroscopic Knot Tying Using Different Surgical Gloves and High–Tensile Strength Sutures

To examine the risk of glove tears associated with arthroscopic knot tying using 4 commonly used high-tensile strength sutures and 2 different types of gloves. We analyzed 2 different surgical latex glove types (0.24-mm-thick powder-free and 0.32-mm-thick powdered) for perforation after arthroscopic knot tying with 4 different high-tensile strength sutures: Hi-Fi (ConMed Linvatec, Largo, FL), Ultrabraid (Smith & Nephew, Memphis, TN), FiberWire (Arthrex, Naples, FL), and Orthocord (DePuy Mitek, Raynham, MA). All knots were tied by a double-gloved single surgeon. Twelve trials of 4 knots each were performed for every glove-suture combination. All gloves were analyzed for perforation by a blinded evaluator using visual inspection, hydro-insufflation, and electroconductivity. The overall incidence of glove perforation was 3.4% and was detectable only by the electroconductivity method; the other 2 methods did not detect any perforations. There was a statistically significantly higher rate (P < .001) of perforations in the 0.32-mm powdered gloves (6.8%) compared with the 0.24-mm powder-free gloves (0%). Perforation of the inner glove occurred 5.7 times more frequently than perforation of the outer glove. However, simultaneous perforation of both the inner and outer gloves did not occur in any set. The Hi-Fi suture was involved in 6 perforations compared with 4 for FiberWire, 3 for Ultrabraid, and 0 for Orthocord. Double gloving provides an adequate surgical barrier between the surgeon and the patient during arthroscopic knot tying with high-tensile strength sutures as indicated by the low incidence of glove perforations in our study in an in vitro biomechanical evaluation. There were no instances of simultaneous perforation of both the inner and outer gloves. All perforations occurred only in the thicker (0.32-mm) powdered gloves. Glove tears and finger lacerations have been reported with the use of high-tensile strength sutures during arthroscopic shoulder surgery, thereby raising a concern for safety and disease transmission. This study addresses these concerns by evaluating the risk of glove tears during arthroscopic knot tying.

A Randomized Prospective Study of Glove Perforation in Orthopaedic Surgery: Is a Thick Glove More Effective?

We compared perforation rates among operative staff who were randomly assigned either thick latex surgical gloves or conventional gloves for use in performing total knee arthroplasty. A total of 1120 gloves were assessed in 70 total knee arthroplasties. Additionally, the degree of tactile sensitivity provided by the gloves was compared using a two-point discrimination (TPD) test. Perforation occurred in 27 surgeries (38.5%) and in 48 gloves (4.29%). Binary logistic regression analysis revealed that the operator was a risk factor for perforation rate (Odds ratio 14.448, P < .0.01) and that the type of glove was not (P = .896). In the TPD test, tactile sensitivity was lower for a thick outer glove than the conventional double glove (P < .001 for each site). Not only did thick surgical gloves lower tactile sensitivity, they also offered no superior protective effect over conventional gloves.

The durability of examination gloves used on intensive care units

BackgroundThe use of examination gloves is part of the standard precautions to prevent medical staff from transmission of infectious agents between patients. Gloves also protect the staff from infectious agents originating from patients. Adequate protection, however, depends on intact gloves. The risk of perforation of examination gloves is thought to correlate with duration of wearing, yet, only very few prospective studies have been performed on this issue.MethodsA total number of 1500 consecutively used pairs of examination gloves of two different brands and materials (latex and nitrile) were collected over a period of two months on two ICU’s. Used gloves were examined for micro perforations using the “water-proof-test” according to EN 455–1. Cox-regression for both glove types was used to estimate optimal changing intervals.ResultsOnly 26% of gloves were worn longer than 15 min. The total perforation rate was 10.3% with significant differences and deterioration of integrity of gloves between brands (p<0.001). Apart from the brand, “change of wound dressing” (p = 0.049) and “washing patients” (p = 0.001) were also significantly associated with an increased risk of perforation.ConclusionMedical gloves show marked differences in their durability that cannot be predicted based on the technical data routinely provided by the manufacturer. Based on the increase of micro perforations over time and the wearing behavior, recommendations for maximum wearing time of gloves should be given. Changing of gloves after 15 min could be a good compromise between feasibility and safety. HCWs should be aware of the benefits and limitations of medical gloves. To improve personal hygiene hand disinfection should be further encouraged.

Glove perforation

Glove perforation

Clinical Issues—May 2013

This MonthImmunization recommendations for perioperative observersKey words: immunization, vaccine, vaccination, perioperative observers, perioperative visitors.Legislation related to the immunization of perioperative observersKey words: immunization, vaccine, vaccination, perioperative observers, perioperative visitors, students, immunization legislation, immunization regulation, immunization law.Scrubbed personnel who are sneezingKey words: sneezing, coughing, saliva, mucus, surgical mask.Length of time after which a surgical mask should be changedKey words: surgical masks, wet, soiled, filtration efficiency, microbial barrier.Removing surgical head coveringsKey words: surgical head coverings, perioperative areas, microbial dispersal.Surgical wound classification change after glove perforationKey words: surgical wound classification, glove perforation, major break, sterile technique, wound contamination.

Reducing Blood-borne Exposure in Interventional Radiology: What the IR Should Know

Interventional radiologists are at risk of exposure to blood-borne pathogens in their day-to-day practice. Percutaneous exposure from unsafe sharps handling, mucocutaneous exposure from body fluid splashes, and glove perforation from excessive wear can expose the radiologist to potentially infectious material. The increasing prevalence of blood-borne pathogens, including hepatitis B and C, and human immunodeficiency virus, puts nurses, residents, fellows, and interventional radiologists at risk for occupational exposure. This review outlines suggestions to establish a culture of safety in the interventional suite.