Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-28T00:30:18.825Z Has data issue: false hasContentIssue false

Study of Blood Contact in Simulated Surgical Needlestick Injuries With Single or Double Latex Gloving

Published online by Cambridge University Press:  02 January 2015

Andreas Wittmann*
Affiliation:
Department of Safety Engineering, University of Wuppertal, Wuppertal, Germany
Nenad Kralj
Affiliation:
Department of Safety Engineering, University of Wuppertal, Wuppertal, Germany
Jan Köver
Affiliation:
Department of Safety Engineering, University of Wuppertal, Wuppertal, Germany
Klaus Gasthaus
Affiliation:
Helios Klinikum Wuppertal, Klinik für Nuklearmedizin, Wuppertal, Germany
Friedrich Hofmann
Affiliation:
Department of Safety Engineering, University of Wuppertal, Wuppertal, Germany
*
University of Wuppertal, Dept. of Safety Engineering, Gauss Str. 20, D-42097 Wuppertal, Germany ([email protected])

Abstract

Objective.

Needlestick injuries are the most common injuries that occur among operation room personnel in the health care service. The risk of infection after a needlestick injury during surgery greatly depends on the quantity of pathogenic germs transferred at the point of injury. The aim of this study was to measure the quantity of blood transferred at the point of a percutaneous injury by using radioactively labeled blood.

Design.

This study was conducted to evaluate the risk of infection through blood contact by simulating surgical needlestick injuries ex vivo. The tests were conducted by puncturing single and double latex gloves with diverse sharp devices and objects that were contaminated with Technetium solution–labeled blood.

Results.

A mean volume of 0.064 μL of blood was transferred in punctures with the an automatic lancet at a depth of 2.4 mm through 1 layer of latex. When the double-gloving indicator technique was used, a mean volume of only 0.011 μL of blood was transferred (median, 0.007 μL); thus, by wearing 2 pairs of gloves, the transferred volume of blood was reduced by a factor of 5.8.

Conclusions.

The results revealed that double gloving leads to a significant reduction in the quantity of blood transferred during needlestick injury.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Makary, MA, Al-Attar, A, Holzmueller, ChG, et al. Needlestick injuries among surgeons in training. N Engl J Med 2007;356:26932699.CrossRefGoogle ScholarPubMed
2.Kralj, N, Beie, M, Hofmann, F. Surgical gloves–how well do the protect against infections? [in German]. Gesundheitswesen 1999;61:398403.Google ScholarPubMed
3.Tanner, J, Parkinson, H. Double gloving to reduce surgical cross-infection. Cochrane Database Syst Rev 2006;(3):CD003087.CrossRefGoogle ScholarPubMed
4.Kralj, N. Handschuhe—infektionsschutz für beschäftigte und patienten. In: Hofmann, F, Reschauer, G, Stößel, U. Arbeitsmedizin im Gesundheitsdienst XIV. Freiburg: FFAS; 2001:100105.Google Scholar
5.Zimmermann, CH, Junghanns, K. Die verwendung eines neuen perforationsindikatorsystems in der chirurgischen routine. Hyg Med 1996;21:486492.Google Scholar
6.Eckersley, JR, Williamson, DM. Glove punctures in an orthopaedic trauma unit. Injury 1990;21:177178.Google Scholar
7.Wright, KU, Moran, CG, Briggs, PJ. Glove perforation during hip arthroplasty: a randomised prospective study of a new taperpoint needle. J Bone Joint Surg 1993;75:918920.Google Scholar
8.Hollaus, PH, Lax, F, Janakiev, D, Wurnig, PN, Pridu, NS. Glove perforation rate in open lung surgery. Eur J Cardiothorac Surg 1999;15:461464.Google Scholar
9.Eklund, AM, Ojajärvi, J, Laitinen, K, Valtonen, M, Werkkala, KA. Glove punctures and postoperative skin flora of hands in cardiac surgery. Ann Thorac Surg 2002;74:149153.CrossRefGoogle ScholarPubMed
10.Beie, M, Kralj, N, Hofmann, F. Gefährdungsanalysen in krankenhäusern. In: Hofmann, F, Reschauer, G, Stößel, U. Arbeitsmedizin im Gesundheitsdienst XII. Freiburg: FFAS; 1999:347364.Google Scholar
11.Popejoy, SL, Fry, DE. Blood contact and exposure in the operating room. Surg Gynec Obstet 1991;172:480483.Google Scholar
12.Rieger, MA, Hasselhorn, HM, Beie, M, Kralj, N, Vetter, HD, Hofmann, F. Personnel-to-patient transmission of hepatitis C virus: underestimation of exposure. Arch Int Med 2000;161:23132316.Google Scholar
13.Heeg, P. Sicherheitsaspekte bei operationshandschuhen. Operat Orthop Traumatol 1993;5:291293.Google Scholar
14.Bennett, B, Duff, P. The effect of double gloving on frequency of glove perforations. Obstet Gynecol 1991;78:10191022.Google Scholar
15.Bebbington, MW, Treissman, MJ. The use of a surgical assist device to reduce glove perforation in post vaginal repair: a randomised control trial. Am J Obst Gynecol 1996;175:862866.CrossRefGoogle Scholar
16.Greco, RJ, Garza, JR. Use of double gloves to protect the surgeon from blood contact during aesthetic procedures. Aesthetic Plast Surg 1995;19:265267.Google Scholar
17.Naver, LPS, Gottrup, F. Incidence of glove perforations in gastrointestinal surgery and the protective effect of double gloves: a prospective, randomised controlled study. Europ J Surg 2003;166:293295.Google Scholar
18.Cole, RP, Gault, CT. Glove perforation during plastic surgery. Br J Plast Surg 1989;42:481483.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;77:458–60.Google Scholar
20.König, M, Bruha, M, Hirsch, HA. Perforation of surgical gloves in gynecologic operations and abdominal Cesarean section [In German]. Geburtsh Frauenheilk 1992;52:109112.Google Scholar
21.Caillot, JL, Cote, C, Abidi, H, Fabry, J. Electronic evaluation of the value of double gloving. Br J Surg 1999;86:13871390.Google Scholar
22.Fisher, MD, Reddy, VR, Williams, VM, Lin, KY, Thacker, JG, Redlich, RF. Biomechanical performance of latex and non-latex double-glove systems. J Biomed Mater Res 1999;48:797806.3.0.CO;2-4>CrossRefGoogle ScholarPubMed
23.Manson, TT, Bromberg, WG, Thacker, JG, McGregor, W, Morgan, RF, Redlich, RF. A new glove puncture detection system. J Emerg Med 1995;13:357364.CrossRefGoogle ScholarPubMed
24.Duron, JJ, Keilani, K, Elian, NG. Efficacy of double gloving with coloured inner pair for immediate detection of operative glove perforations. Eur J Surg 1996;162:941944.Google Scholar
25.Beie, M, Kralj, N, Sieker, S, Hofmann, F. Infektionsschutz im arbeitsleben-studien zum tastsinn bei einfacher bzw. doppelter behandschuhung. In Schäcke, G, Lüth, P. Dokumentationsband über 40. Jahrestagung der DGAUM. Rindt Druck: Fulda; 2000:310312.Google Scholar
26.Novak, CB, Patterson, MM, Mackinnon, SE. Evaluation of hand sensibility with single and double latex gloves. Plast Reconstr Surg 1999;1:128131.CrossRefGoogle Scholar