Temporal Effects on Intra-operative Bacterial Contamination of Surgical Gloves in Non-Infection Orthopaedic Trauma...

Surgical site infections (SSIs) are among the most serious complications in Orthopaedic trauma surgery, contributing to patient morbidity, mortality, and substantial financial costs. With direct inoculation from intra-operative bacterial contamination being a large contributor to these infections, the temporal dynamics of intra-operative bacterial colonization on surgical gloves in Orthopaedic trauma cases was investigated.

Surgical glove bacterial cultures were taken by firmly pressing the operating room staff members gloved fingertips onto a sheep's blood agar plate. Cases, without known pre-existing infection, were chosen from a single level 1 trauma center at random between 2023-2025. Samples were obtained at two intra-operative time points: (1) immediately after draping and (2) after implant placement but prior to final irrigation. These samples were compared to negative controls of freshly donned, but unused sterile gloves. Glove imprints were which were then incubated for two weeks, and bacterial isolates were identified using MALDI-TOF mass spectrometry.

Of 276 total gloves sampled, 70 (25.4% 70/138) demonstrated bacterial growth, compared with 0 controls (0%, 0/138 p<0.001). Contamination was detected in 18.8% of gloves after draping and 31.9% after implant placement. Pelvic procedures had the highest contamination rate by surgical location (58.3%, p<0.05 vs. 20.2% upper extremities and 25.5% lower extremities). Compared to gloves without bacterial growth, mean glove wear duration was longer for contaminated gloves (86.5 vs. 77.4 minutes, p=0.043), with significantly lower rates observed at ≤75 minutes of wear (p=0.049). The most common isolate was Staphylococcus epidermidis (20.5%), which was more commonly grown at the second collection time point.

Intra-operative surgical gloves demonstrated high rates of bacterial contamination, particularly with longer procedure times. Routine glove changes after draping, after final implant placement, and after >75 minutes of operating time may be a simple, low-cost strategy to reduce potential SSI risk.

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