Comparison of glove donning techniques for the likelihood of gown contamination. An infection control study

The creation of an optimal environment, whenever major joints are opened or metal is implanted into bone, is important to reduce infection following orthopaedic surgery. Following normal hand washing protocols, it is possible that pathogenic bacteria can remain on the skin. These bacteria may inadvertently be transferred to the surgical gown during the glove donning procedure and therefore contamination of the surgical wound could follow. We aimed to determine whether there is a difference between three differing glove donning techniques, open, closed and scrub staff assisted, in terms of accidental gown contamination, as the optimum method is unknown. Three differing glove donning techniques were assessed using ultra-violet (UV) lotion, applied to the hands after the scrub, to demonstrate patches of contamination on the surgical gowns. Two studies were carried out. An initial pilot study with theatre personnel and the main study by a single surgeon rehearsed in the various techniques. The region and size of contamination patches were documented. In the pilot study 12 out of 13 individuals were seen to have patches of UV fluorescent gown contamination following an observed scrub. In the main study, both the open and closed technique had a 100% gown contamination rate. This was concentrated around the cuff region. There were no contamination patches in the scrub staff assisted technique. Glove donning, using the scrub staff assisted technique can minimise the possibility of gown contamination. This is important in surgical procedures where the results of infection can be devastating.