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Incidence of Microperforation for Surgical Gloves Depends on Duration of Wear

Published online by Cambridge University Press:  02 January 2015

Lars Ivo Partecke ,
Anna-Maria Goerdt ,
Inga Langner ,
Bernd Jaeger ,
Ojan Assadian ,
Claus-Dieter Heidecke ,
Axel Kramer  and
Nils-Olaf Huebner
Lars Ivo Partecke
Affiliation:
Clinic of General, Visceral, Vascular, and Thoracic Surgery, Department of Surgery, Ernst-Moritz-Arndt University, Greifswald, Germany
Anna-Maria Goerdt
Affiliation:
Institute of Hygiene and Environmental Medicine, Ernst-Moritz-Arndt University, Greifswald, Germany
Inga Langner
Affiliation:
Clinic of General, Visceral, Vascular, and Thoracic Surgery, Department of Surgery, Ernst-Moritz-Arndt University, Greifswald, Germany
Bernd Jaeger
Affiliation:
Institute of Biometrics, Ernst-Moritz-Arndt University, Greifswald, Germany
Ojan Assadian*
Affiliation:
Department of Hygiene and Medical Microbiology, Medical University of Vienna, Vienna, Austria
Claus-Dieter Heidecke
Affiliation:
Clinic of General, Visceral, Vascular, and Thoracic Surgery, Department of Surgery, Ernst-Moritz-Arndt University, Greifswald, Germany
Axel Kramer
Affiliation:
Institute of Hygiene and Environmental Medicine, Ernst-Moritz-Arndt University, Greifswald, Germany
Nils-Olaf Huebner
Affiliation:
Institute of Hygiene and Environmental Medicine, Ernst-Moritz-Arndt University, Greifswald, Germany
*
Department of Hygiene and Medical Microbiology, Medical University Vienna, Vienna General Hospital, Waehringer Guertel 18-20, 1090 Vienna, Austria ([email protected])
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Abstract

Background.

The use of sterile gloves is part of general aseptic procedure, which aims to prevent surgical team members from transmitting infectious agents to patients during procedures performed in an operating room. In addition, surgical gloves also protect team members against patient-transmitted infectious agents. Adequate protection, however, requires that the glove material remain intact. The risk of perforations in surgical gloves is thought to correlate with the duration of wear, yet very few prospective studies have addressed this issue.

Methods.

We prospectively collected 898 consecutive pairs of used surgical gloves over a 9-month period in a single institution. After surgical team members wore the gloves during surgical procedures, the gloves were examined for microperforations using the watertight test described in European Norm 455, part 1. The gloves were analyzed as a pair; if 1 glove had a perforation, the pair was considered to be perforated. In addition, we evaluated the use of a hand cream that contained a suspension of cornstarch and ethanol to determine its potential influence on the rate of microperforation.

Results.

Wearing gloves for 90 minutes or less resulted in microperforations in 46 (15.4%) of 299 pairs of gloves, whereas wearing gloves for 91-150 minutes resulted in perforation of 54 (18.1%) of 299 pairs, and 71 of (23.7%) of 300 pairs were perforated when the duration of wear was longer than 150 minutes (P = .05). Subgroup analysis revealed no significant difference in the rates of microperforation for surgeons (56 [23.0%] of 244 pairs of gloves perforated), first assistants (43 [19.0%] of 226 pairs perforated), and surgical nurses (53 [20.5%] of 259 pairs perforated). Of 171 microperforations, 114 (66.7%) were found on the left hand glove (ie, the glove on subjects' nondominant hand), predominantly on the left index finger (55 [32.3%]). The use of the hand cream had no influence on the rate of microperforation.

Conclusion.

Because of the increase in the rate of microperforation over time, it is recommended that surgeons, first assistants, and surgical nurses directly assisting in the operating field change gloves after 90 minutes of surgery.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 30 , Issue 5 , May 2009 , pp. 409 - 414
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

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References

1.Tanner, J. Surgical gloves: perforation and protection. J Perioper Pract 2006;16:148–152.Google ScholarPubMed
2.Caillot, JL. Surgical glove use in France. J Chir 2005;142:226–230.CrossRefGoogle ScholarPubMed
3.European Committee for Standardization. EN 455. Medical gloves for single use. Brussels: European Committee for Standardization; 2000.Google Scholar
4.Tanner, J, Parkinson, H. Double gloving to reduce surgical cross-infection. Cochrane Database Syst Rev 2006;3:CD003087.Google Scholar
5.Kralj, N, Beie, M, Hofmann, F. Surgical gloves-how well do they protect against infections? Gesundheitswes 1999;61:398–403.Google Scholar
6.Ventolini, G, Neiger, R, McKenna, D. Decreasing infectious morbidity in cesarean delivery by changing gloves. J Reprod Med 2004;49:13–16.Google ScholarPubMed
7.The German-Speaking Working Group for Hospital Hygiene (AWMF). Hand disinfection and hand hygiene. Hyg Med 2008;33:300-313. Available at: http://www.uni-duesseldorf.de/WWW/AWMF/. Accessed March 27, 2009.Google Scholar
8.Chapman, S, Duff, P. Frequency of glove perforations and subsequent blood contact in association with selected obstetric surgical procedures. Am J Obstet Gynecol 1993;168:1354–1357.Google Scholar
9.Laine, T, Kaipia, A, Santavirta, J, Aarnio, P. Glove perforations in open and laparoscopic abdominal surgery: the feasibility of double gloving. Scand J Surg 2004;93:73–76.Google Scholar
10.Eklund, AM, Ojajarvi, J, Laitinen, K, Valtonen, M, Werkkala, KA. Glove punctures and postoperative skin flora of hands in cardiac surgery. Ann Thorac Surg 2002;74:149–153.CrossRefGoogle ScholarPubMed
11.Brough, SJ, Hunt, TM, Barrie, WW. Surgical glove perforations. Br J Surg 1988;75:317.Google Scholar
12.Brown, JN. Surgeon protection: early recognition of glove perforation using a green under glove. J R Coll Surg Edinb 1996; 41:395–396.Google Scholar
13.Burke, FJ, Baggett, FJ, Lomax, AM. Assessment of the risk of glove puncture during oral surgery procedures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:18–21.Google Scholar
14.Al-Maiyah, M, Bajawa, A, Mackenney, P, et al. Glove perforation and contamination in primary total hip arthroplasty. J Bone Joint Surg Br 2005;87:556–559.CrossRefGoogle ScholarPubMed
15.Kojima, Y, Ohashi, M. Unnoticed glove perforations during thoracoscopic and open thoracic surgery. Ann Thorac Surg 2005;80:1078–1080.Google Scholar
16.Maffulli, N, Capasso, G, Testa, V. Glove perforation in pediatric orthopaedic surgery. J Pediatr Orthop 1991;11:25–27.CrossRefGoogle ScholarPubMed
17.Skaug, N. Micropunctures of rubber gloves used in oral surgery. Int J Oral Surg 1976;5:220–225.Google Scholar
18.Marin-Bertolin, S, Gonzalez-Martinez, R, Gimenez, CN, Marquina Vila, P, Amorrortu-Velayos, J. Does double gloving protect surgical staff from skin contamination during plastic surgery? Plast Reconstr Surg 1997;99:956–960.Google Scholar
19.Thomas, S, Agarwal, M, Mehta, G. Intraoperative glove perforation-single versus double gloving in protection against skin contamination. Postgrad Med J 2001;77:458–460.Google Scholar
20.Caillot, J-L, Paparel, P, Arnal, E, Schreiber, V, Voiglio, EJ. Anticipated detection of imminent surgeon-patient barrier breaches, a prospective randomized controlled trial using an indicator underglove system. World J Surg 2006;30:134–138.Google Scholar