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The rate of glove perforations in orthopaedic procedures: single versus double gloving. A prospective study
1Department of Orthopaedics, University Malaya Medical Center, 50603 Kuala Lumpur, Malaysia.
Abstract:
Glove perforation during surgery has always been a matter of concern as it increases the infection rate and the risk of transmission of blood borne diseases. To determine the common causes, the site and the awareness of glove perforations in orthopaedic surgery, a prospective study was conducted to assess the rate of glove perforation during 130 consecutive orthopaedic operations. All gloves worn by the surgical team were assessed after the surgery using the water-loading test. A total of 1452 gloves were tested, and the rate of perforation was 3.58%. Most of these perforations (61.5%) were unnoticed. The main surgeons had the most perforations (76.9%), followed by first assistants (13.5%) and second assistants (9.6%). Most perforations occurred at the non-dominant hand. The commonest site of perforation was the index finger followed by the thumb. Shearing force with instruments accounted for 45% of the noticed perforations. Majority of these occurred during nailing procedures (33%) and internal fixation without the use of wires (19%). Our rate of glove perforation is similar to other series. Most of them went unnoticed and were mainly due to shearing injuries rather than perforation by sharps. Therefore, there is an increased risk of contamination and break in asepsis during surgery.
Insights
Surgical glove perforation occurs at a rate of 3.58%, with most unnoticed. Shearing injuries, not sharps, are the primary cause, increasing infection risk during orthopaedic surgery.
Area of Science:
- Orthopaedic Surgery
- Infection Control
- Surgical Safety
Background:
- Glove perforation during surgery poses risks of infection and blood-borne disease transmission.
- Understanding perforation causes and awareness is crucial for surgical teams.
Purpose of the Study:
- To determine the rate, common causes, sites, and awareness of glove perforations in orthopaedic surgery.
Main Methods:
- Prospective study assessing 1452 gloves from 130 orthopaedic operations.
- Water-loading test used to detect perforations post-surgery.
- Analysis of perforation location, cause, and surgical role.
Main Results:
- Overall perforation rate was 3.58%, with 61.5% unnoticed.
- Main surgeons experienced most perforations (76.9%), primarily on the non-dominant hand's index finger or thumb.
- Shearing forces from instruments caused 45% of noticed perforations, common in nailing and internal fixation procedures.
Conclusions:
- Glove perforation is a significant, often unnoticed, risk in orthopaedic surgery.
- Shearing injuries are more prevalent than sharp-induced perforations.
- Increased risk of contamination and compromised asepsis necessitates improved prevention strategies.
