Double gloving to reduce surgical cross-infection

Area of Science:

• Surgical Safety
• Infection Control
• Medical Device Performance

Background:

• Surgery poses a high risk of pathogen transmission due to blood exposure, potentially causing infections in patients and surgical teams.
• Protective barriers, such as surgical gloves, are crucial for mitigating infection risks during surgical procedures.
• Double gloving is hypothesized to provide an enhanced barrier against pathogen transfer compared to single gloving.

Purpose of the Study:

• To evaluate if double gloving reduces post-operative or blood-borne infections in patients and surgical teams compared to single gloving.
• To assess if double gloving decreases the incidence of surgical glove perforations, particularly for the innermost glove.

Main Methods:

• Conducted a systematic review of randomized controlled trials comparing single gloving, double gloving, glove liners, and indicator systems.
• Searched major medical databases (Cochrane Wounds Group, MEDLINE, CINAHL, EMBASE) and contacted industry sources.
• Independently assessed trial relevance and quality, with data extraction and cross-checking by two reviewers.

Main Results:

• Double latex gloving significantly reduced perforations in the innermost glove compared to single gloving in low-risk surgical specialties.
• Glove liners and cloth outer gloves further reduced innermost glove perforations in joint replacement surgery compared to double latex gloves.
• Indicator gloves improved detection of outer glove perforations but not inner glove perforations.

Conclusions:

• Double latex gloving offers enhanced protection by significantly reducing inner glove perforations in many surgical settings.
• Specialized interventions like glove liners and cloth outer gloves provide additional protection for the innermost glove in high-risk procedures.
• While indicator gloves aid outer glove awareness, they do not enhance protection for the innermost barrier.