Glove Puncture Research Articles

The incidence of glove puncture during caesarean section

SummaryFollowing 200 caesarean sections the operators' gloves were examined for perforations. In 107 (54%) of the cases one or both of the surgeon's gloves were perforated. The frequency of perforation was the same in elective and in emergency caesarean sections, but was less if the uterus was not eventrated. The frequency of glove perforation in this study is the highest of any surgical operation yet reported.

Damage to physicians' gloves during “routine” cardiac catheterization: An underappreciated occurrence

Recently, concern for the protection of health care employees and health care recipients has led to increasing awareness of transmitted infections. However, it is evident that damage of barrier methods of controlling infection can occur and go undetected. In a prospective study conducted from January 13, 1989 through February 15, 1989, 100 sequential pairs of gloves (200 gloves) worn during routine pediatric cardiac catheterizations were evaluated for punctures. A control group of 25 pairs of unused physicians' gloves was also evaluated for the presence of spontaneous leakage.In the 25 pairs of unused gloves (50 gloves), no punctures were detected, whereas in the 200 gloves worn during the catheterization procedures, punctures were found in 38 gloves or 19% (p < 0.001). When comparing the frequency of punctures with respect to the digits, 81% of the punctures were detected within the thumb and index finger of the gloves. In the majority of instances, physicians describe stopcock manipulation as the cause of the punctures. Implication of the stopcock as a possible mechanism for glove damage can be isolated to the stop mechanism on the stopcock pivot.Although surgeons' gloves are worn in many procedures besides surgery, no previous studies have defined the incidence of glove punctures during these procedures. Recommendations include a redesign of the stopcock as a protective measure and immediate change of latex surgeons' gloves whenever damage is suspected.

Bacteriological sampling of postmortem rooms.

Thirty hospital and coroners' postmortem rooms in the West Midlands were visited over two years. The design, environmental facilities, and hygienic practices were investigated and air exchange rates were measured. Microbiological samples were taken from the environment and from gloves, hands, and protective clothing of staff. Glove punctures were also recorded and a plastic isolator evaluated. Bacterial counts in the air were low and related more to the number of people in the room than to the air exchange rate. There was little evidence of the production of aerosol containing bacteria, although splashing occurred while intestines were being washed out. Surfaces often remained contaminated with Gram negative bacilli after cleaning but numbers were considerably reduced on drying. Decontamination of instruments was satisfactory. A wide range of disinfectants and concentrations was used, but none showed evidence of contamination. Gloves were heavily contaminated after use, and occasionally the hands of the wearer after removal of the gloves. Washing the hands effectively removed residual transient organisms, irrespective of the agent used. The incidence of glove punctures was higher among technicians (38%) than pathologists (12%). The plastic isolator reduced smells and limited environmental contamination but visibility and acceptability were poor. The results of the study suggest that there is little evidence of risk of infection to staff, providing basic hygienic precautions are taken, but consideration should be given to the prevention of glove punctures.

Wound infection surveillance.

This paper describes a prospective study of all surgical wounds of patients at the Foothills Hospital (Calgary, Alberta, Canada) during a period of 10 years to determine the rate of infection of surgical wounds and to assess the factors that influenced this rate. My colleagues and I found that the overall infection rate was 4.7% but that the rate of infection of clean wounds was 1.5%; this latter rate proved to be far more useful than the former as an indicator of control of infections of surgical wounds. Endogenous contamination at the time of operation is more important as a cause of infection than is exogenous contamination. Having the patient shower with an antiseptic agent before the operation and not shaving the operative site reduced the clean wound infection rate. Use of adhesive plastic drapes did not reduce the infection rate. Glove punctures did not prove hazardous. Advanced age of the patient, prolonged preoperative hospitalization, and long operations were associated with an increase in the rate of infection of surgical wounds.