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A prospective study on the risk of glove fingertip contamination during draping in joint replacement surgery
Introduction:
The aim of this prospective study was to investigate the risk of contamination of surgical gloves during preparation and draping in joint replacement surgery.
Methods:
During 46 hip and knee replacement procedures, the gloves of orthopaedic consultants (n=5) and registrars (n=3) were assessed for contamination immediately after draping by impression of gloved fingers on blood agar. Contamination was evaluated by the surgeon's grade, the type of procedure, the role of the assistant and the dominance of the hand.
Results:
A total of 125 pairs of top gloves were examined (79 pairs from registrars and 46 pairs from consultants). Bacterial contamination was isolated on 19 pairs (15.2%) (16 pairs from registrars and 3 pairs from consultants, p=0.04). Coagulase negative staphylococci were the main isolates and contamination was considered low in all cases (1-5 colonies). Contamination was seen more on the dominant hand (16 gloves from dominant hands and 6 from non-dominant hands, p=0.04), on the index finger and thumb. More contaminated gloves were seen in hip arthroplasty procedures (16 pairs from total hip replacements vs 3 pairs from total knee replacements, p=0.02).
Conclusions:
Contamination of glove fingertips during draping in joint replacement procedures is more likely to occur among junior surgeons, in hip rather than knee arthroplasty procedures and on the dominant hand. It is therefore essential that surgeons of different grades replace gloves used in draping to avoid exposing patients to the risk of infection.
Insights
Surgical glove contamination during joint replacement surgery is more common in junior surgeons, during hip replacements, and on the dominant hand. Replacing gloves after draping is crucial to prevent patient infection risks.
Area of Science:
- Orthopaedic Surgery
- Infection Control
- Surgical Microbiology
Background:
- Surgical site infections are a significant concern in joint replacement procedures.
- Maintaining aseptic technique, including glove integrity, is paramount to prevent bacterial contamination.
Purpose of the Study:
- To prospectively evaluate the risk of surgical glove contamination during the preparation and draping phases of hip and knee replacement surgeries.
- To identify factors associated with increased glove contamination rates.
Main Methods:
- Assessed glove contamination via blood agar impression for 125 pairs of gloves from orthopaedic surgeons (consultants and registrars) during 46 joint replacement procedures.
- Analyzed contamination based on surgeon's grade, procedure type, assistant's role, and hand dominance.
Main Results:
- Bacterial contamination was detected on 15.2% of gloves, primarily coagulase-negative staphylococci.
- Contamination was significantly higher in registrars (12.6%) compared to consultants (2.6%) (p=0.04).
- Higher contamination rates were observed on the dominant hand (p=0.04) and during hip arthroplasty compared to knee arthroplasty (p=0.02).
Conclusions:
- Glove contamination during draping is more prevalent in junior surgeons, hip procedures, and on the dominant hand.
- Recommendations include glove replacement after draping to mitigate infection risk for patients undergoing joint replacement surgery.
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