Hands Deserve Better: A Systematic Review on Surgical Glove Fit and Provider Performance

Background: The maintenance of an aseptic barrier between the surgical team and patient aids in the prevention of exposure of the patient to pathogens. Variations in gloving practice may have safety implications due to glove failure. An important relationship exists between optimum glove fit and manual dexterity, tactile sensitivity, and fatigue. The aim of this systematic review was to assess the presence and quality of the available literature that investigates the critical association between glove fit and provider performance in the operating theatre and to ascertain whether there is an established standard to determine appropriate glove size. Methods: A systematic review of the literature was undertaken in accordance with the PRISMA statement using one distinct research question regarding glove fit (INPLASY2025100008). Searches on PubMed, Embase, Cochrane Collaboration of Systematic Reviews and Metanalyses and Google Scholar were performed between 1 May 2022 and 24 January 2023. Studies were assessed for eligibility against pre-defined inclusion and exclusion criteria. Risk of bias was determined using multiple assessment tools. Results: This systematic review included 18 studies, nine of which were high-quality Level I or II trials, and multiple observational analyses. Poor glove fit was consistently associated with reduced manual dexterity, impaired tactile sensitivity, and decreased comfort, while oversized or undersized gloves increased the risk of glove perforation and fatigue. These findings underscore the clinical importance of appropriate glove sizing to optimize surgical performance and safety. Conclusions: There is a scarcity of high-quality studies investigating the relationship of glove fit and performance. Furthermore, there does not appear to be a standard method to determine the optimal glove fit for members of the surgical team, nor are there practical examples of how glove size is determined. Further research in this area is required.