Occult surgical glove perforations in otolaryngology-head and neck surgery

With the advent of the acquired immunodeficiency syndrome crisis, it has become imperative that all surgeons minimize their risk of direct contact with the patient's body fluids. In the course of performing surgery, perforations are frequently created in surgical gloves, which often go unnoticed. This study determined the frequency with which occult glove perforations occurred in 134 consecutive head and neck surgical procedures. One thousand fifty gloves (650 gloves used in surgery, 400 unused control gloves) were analyzed for the presence of perforations large enough to permit the passage of fluid. An unrecognized glove perforation was detected in 25% of surgical cases. The duration of surgery correlated strongly and positively with the incidence of perforation. Perforation rates varied widely for specific types of procedures, and are reported for each of the five subdivisions within otolaryngology-head and neck surgery. The implications of these results are described, and recommendations for the use of protective measures, especially in reference to the use of double-gloving, are made.