Contamination Associated With Glove Changing Techniques in the Operating Theatre

Area of Science:

• Surgical Safety
• Infection Control
• Medical Device Performance

Background:

• Maintaining a sterile operative field is crucial for preventing surgical site infections.
• Double gloving is standard practice, with outer glove changes for contamination.
• No prior studies compared intra-operative top glove changing techniques.

Purpose of the Study:

• To evaluate and compare the effectiveness of different intra-operative top glove changing techniques.
• To identify the technique that results in the least surface contamination of the sterile field.

Main Methods:

• Three glove changing methods were tested using Glitterbug™ (UV fluorescent powder).
• Method 1: Wore 3 pairs, removed the outer pair.
• Method 2: Wore 2 pairs, removed and replaced the top glove unassisted.
• Method 3: Wore 2 pairs, removed and replaced the top glove with scrub nurse assistance.
• Contamination was assessed under UV light by a blinded investigator across 210 trials.

Main Results:

• Method 2 (unassisted replacement) demonstrated a statistically significant lower overall contamination rate (75%) compared to Method 1 (92%) and Method 3 (79%).
• Method 3 (assisted replacement) showed the lowest rate of direct contamination (25%), significantly lower than Method 1 (59%) and Method 2 (37%).
• Both direct contact and airborne spread contributed to contamination.

Conclusions:

• Wearing two pairs of gloves and replacing the outer glove, whether assisted or unassisted, can reduce surface contamination.
• Method 2 (unassisted replacement) is effective in lowering overall contamination.
• Method 3 (assisted replacement) is particularly effective in minimizing direct contact contamination.