Surgical glove perforation in obstetrics

Area of Science:

• Obstetrics and Gynecology
• Infectious Disease Prevention
• Surgical Safety

Background:

• Surgical glove perforation poses a significant risk of blood-borne pathogen exposure for obstetricians.
• Unrecognized perforations during procedures increase infection transmission potential.
• Vaginal and cesarean deliveries involve high-risk environments for glove integrity.

Purpose of the Study:

• To determine the incidence and identify risk factors for surgical glove perforation during obstetric procedures.
• To assess the rate of unrecognized glove perforations in this setting.
• To inform strategies for reducing surgical site infections and healthcare worker exposure.

Main Methods:

• Examined 754 surgical gloves from vaginal deliveries, cesarean deliveries, and postpartum tubal ligations.
• Utilized the air inflation-water submersion technique to detect perforations.
• Conducted multivariate logistic regression analysis to identify risk factors.

Main Results:

• An overall surgical glove perforation rate of 13.3% was observed.
• 62% of these perforations went unrecognized during the surgical procedures.
• Major risk factors included cesarean delivery (OR 3.52), vaginal lacerations/episiotomy (OR 4.95), and chief resident status (OR 3.00).
• Nondominant hand fingers were the most common site of perforation.

Conclusions:

• Surgical glove perforation is common in obstetrics, with a high rate of undetected breaches.
• Cesarean delivery, vaginal trauma, and surgeon experience level are significant risk factors.
• Attention to surgical technique by all team members is crucial for preventing glove perforations and ensuring patient and provider safety.