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Double gloving to reduce surgical cross-infection
1Derby Hospitals NHS FoundationTrust, Derby City General Hospital, Uttoxeter Road, Derby, Derbyshire, UK DE22 3NE. judith.tanner@derbyhospitals.nhs.uk
The Cochrane Database of Systematic Reviews
|July 21, 2006
Summary
Wearing double surgical gloves significantly reduces glove perforations, protecting surgical teams and patients from pathogen transfer. While direct evidence on infection reduction is limited, enhanced glove protection is crucial for safety.
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 essential to mitigate contamination risks during surgical procedures.
- Multiple glove layers (double, triple gloving) are hypothesized to offer enhanced protection compared to single-gloving.
Purpose of the Study:
- To evaluate if additional glove protection (e.g., double gloving) reduces surgical site infections or blood-borne infections in patients and surgical teams.
- To assess the impact of additional glove protection on the rate of surgical glove perforations, particularly for the innermost glove.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials comparing different surgical gloving strategies.
- Searched major databases (Cochrane Wounds Group, CENTRAL) and contacted manufacturers for relevant studies.
- Included trials evaluating single, double, triple gloving, glove liners, knitted outer gloves, and perforation indicator systems.
Main Results:
- No direct evidence was found linking additional glove protection to reduced surgical site infections, though the review lacked power for this outcome.
- Double gloving significantly reduced perforations in the innermost glove compared to single gloving (OR 4.10).
- Triple gloving, glove liners, and knitted outer gloves also significantly decreased innermost glove perforations compared to standard double gloving.
Conclusions:
- While direct evidence for reducing surgical site infections is insufficient, enhanced glove protection demonstrably reduces glove perforations.
- Double gloving, triple gloving, glove liners, and knitted outer gloves offer superior protection against glove perforation.
- Perforation indicator systems increase the detection of innermost glove perforations during surgery.
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