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Glove perforation during surgery: what are the risks?
1Royal Victoria Infirmary, Newcastle upon Tyne.
Abstract:
Surgical gloves are important in protecting medical staff from exposure to pathogens during surgery, especially viruses such as hepatitis B and the human immunodeficiency virus. We have studied the incidence and circumstances of surgical glove perforation using a sensitive electronic device. The glove perforation rate during elective general surgery was compared with that seen during an anastomosis workshop, where surgical trainees operated in a laboratory setting. A total of 220 gloves were tested for perforations pre- and postoperatively during general elective surgical procedures. During the surgical training workshop 72 gloves were tested. Fifty-two gloves (24%) were perforated during surgical procedures. Among surgeons, consultants had a significantly lower perforation rate than trainees (26% vs 46%, P < 0.05, chi 2), that for assistants was much lower (9%). The perforation rate for scrub nurses was surprisingly high at 22%. Glove perforation among trainees was significantly lower during workshop procedures than at elective surgery (17% vs 46%, P < 0.05, chi 2), probably because glove perforation occurs commonly at wound closure. Glove perforation remains very common, particularly among surgical trainees. Glove perforation should be reduced by teaching better techniques, especially 'no-touch', particularly for wound closure.
Insights
Surgical glove perforation is common, especially for trainees. Improving surgical techniques, like the
Area of Science:
- Medical devices
- Surgical safety
- Infection control
Background:
- Surgical gloves are critical barriers against pathogen exposure for healthcare professionals.
- Understanding surgical glove perforation rates is essential for patient and staff safety.
- Viruses like hepatitis B and HIV pose significant risks during surgical procedures.
Purpose of the Study:
- To investigate the incidence and circumstances of surgical glove perforation.
- To compare perforation rates in elective general surgery versus a simulated training environment.
- To identify factors contributing to glove perforation among surgical staff.
Main Methods:
- Utilized a sensitive electronic device to detect perforations in surgical gloves.
- Tested 220 gloves during elective general surgery and 72 gloves during a surgical training workshop.
- Collected data on perforation rates across different surgical roles (consultants, trainees, assistants, scrub nurses).
Main Results:
- Overall, 24% of gloves were perforated during surgical procedures.
- Surgical trainees exhibited significantly higher perforation rates (46%) compared to consultants (26%) and assistants (9%).
- Scrub nurses also showed a high perforation rate (22%); trainees had lower rates in workshops (17%) than during surgery (46%).
Conclusions:
- Surgical glove perforation is a prevalent issue, particularly affecting surgical trainees.
- Perforation rates are influenced by surgical experience and the specific stage of surgery, with wound closure being a critical point.
- Enhanced training in techniques like 'no-touch' during wound closure is recommended to reduce glove perforations.