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Occult glove perforation during ophthalmic surgery
1Jules Stein Eye Institute, UCLA School of Medicine.
Abstract:
We examined the latex surgical gloves used by 56 primary surgeons in 454 ophthalmic surgical procedures performed over a 7-month period. Of five techniques used to detect pinholes, air inflation with water submersion and compression was found to be the most sensitive, yielding a 6.80% prevalence in control glove pairs and a 21.8% prevalence in postoperative study glove pairs, for a 15.0% incidence of surgically induced perforations (P = 0.000459). The lowest postoperative perforation rate was 11.4% for cataract and intraocular lens surgery, and the highest was 41.7% for oculoplastic procedures. Factors that correlated significantly with the presence of glove perforations as determined by multiple logistic regression analysis were oculoplastic and pediatric ophthalmology and strabismus surgical procedures, surgeon's status as a fellow in training, operating time, and glove size. The thumb and index finger of the nondominant hand contained the largest numbers of pinholes. These data suggest strategies for reducing the risk of cross-infection during ophthalmic surgery.
Insights
Ophthalmic surgeons experienced a 15.0% incidence of surgically induced glove perforations. This study highlights risks and suggests strategies to reduce cross-infection during eye surgery.
Area of Science:
- Ophthalmology
- Surgical Safety
- Infectious Disease Control
Background:
- Latex surgical gloves are critical barriers in ophthalmic surgery.
- Glove perforations can lead to cross-infection and complications.
- Understanding perforation incidence and risk factors is essential for patient safety.
Purpose of the Study:
- To determine the incidence of surgically induced perforations in latex surgical gloves during ophthalmic procedures.
- To identify the most sensitive method for detecting glove pinholes.
- To analyze factors associated with glove perforations in ophthalmic surgery.
Main Methods:
- Examined 56 surgeons' latex gloves over 7 months in 454 ophthalmic procedures.
- Evaluated five pinhole detection techniques; air inflation with water submersion and compression was most sensitive.
- Utilized multiple logistic regression to identify correlating factors for glove perforations.
Main Results:
- A 15.0% incidence of surgically induced glove perforations was observed (P = 0.000459).
- Postoperative perforation rates varied by procedure type, from 11.4% (cataract surgery) to 41.7% (oculoplastic procedures).
- Significant risk factors included oculoplastic/pediatric/strabismus surgeries, trainee status, operating time, and glove size; thumbs and index fingers of the non-dominant hand were most affected.
Conclusions:
- Surgically induced glove perforations are a significant concern in ophthalmic surgery.
- Specific procedures and surgeon factors increase perforation risk.
- Implementing targeted strategies can mitigate cross-infection risks during ophthalmic procedures.