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Glove perforations during open surgery for gynaecological malignancies
A P Manjunath1, J H Shepherd, D P J Barton
1Department of Gynecologic Oncology, Royal Marsden Hospital, London, UK. manjunath.ap@manipal.edu
Summary
Glove perforations are frequent during gynecological cancer surgeries, affecting 93% of procedures. Clinical fellows face the highest risk, with many perforations going unnoticed and undetected by indicator systems.
Area of Science:
- Surgical Safety
- Medical Device Auditing
- Gynecological Oncology
Background:
- Surgical site infections and complications can arise from unnoticed glove perforations during procedures.
- Maintaining surgical field integrity is crucial in gynecological cancer surgeries.
Purpose of the Study:
- To audit the incidence and characteristics of glove perforations during laparotomies for gynecological cancers.
Main Methods:
- A prospective audit was conducted over 3 months in a gynecological oncology unit.
- Gloves from 29 laparotomies were tested for perforations using air inflation and water immersion.
- Data collected included procedure type, perforation site, glove type, surgeon seniority, operation time, and awareness of perforations.
Main Results:
- Glove perforations were found in 93% of laparotomies, with a 13% perforation rate per glove.
- Perforation rates increased significantly with surgeries exceeding 5 hours and were highest for clinical fellows (94%).
- Perforations commonly occurred on the index finger/thumb, on the non-dominant hand, and were often unnoticed (50%). Double gloving and indicator systems showed some benefit but were not fully effective.
Conclusions:
- Glove perforations are highly prevalent in gynecological cancer laparotomies, posing a significant risk.
- Clinical fellows are particularly vulnerable, and perforations frequently go undetected.
- Improvements in gloving strategies and detection methods are warranted to enhance patient safety.
