The mechanisms and risks of surgical glove perforation

Intact surgical gloves are a barrier to hepatitis B virus and human immunodeficiency virus (HIV) but once perforated during surgery they cannot sustain adequate defence. This study examines the rate of glove perforations during surgery at a District General Hospital. In total, 275 pairs of gloves were collected from 100 consecutive operations. In the 43% of gloves that had been damaged 200 perforations were recorded. The mean rate per operation in the surgeon's gloves was 1.18. Injuries to the non-dominant index finger were significantly higher than injuries to other parts of the hand. Injuries occurred particularly during manipulation of the needles and at wound closure. Consultants were more likely to have glove perforation than juniors. Operations requiring manipulation of instruments deep within the wound had a higher rate than those on the surface. The results of the study indicate that a surgeon risks more than one hepatitis B infection per lifetime and that at least one in 1500 surgeons is likely to be infected by HIV during the next 35 years.