The Intriguing History of Gloves and Their Application to Surgery

Many millennia ago, gloves were devised for protection, first from the cold and then to protect the hands from injury. In time, they became associated with social class, wealth and as a sign of privilege. With status and prestige followed the glamour and commercialism of fashion. Surgeons had little interest in gloves until relatively recently unless they were dealing with foul and putrid wounds. The first serious use of gloves in surgery was to protect hands from the irritating effects of antiseptics such as mercuric chloride-until Joseph Bloodgood noticed that they also markedly reduced surgical infection rates. Soon glove-wearing became routine in surgery and the drive, promoted by glove manufacturers, moved to expansion of their use. An example of this is the increased use of double-gloving for elective soft tissue surgery. The obsession to reduce infection at all costs (based on theoretical grounds from observing glove micro-perforations after surgery) without any evidence of actual benefit to patient or surgeon (no RCT has shown reduction in SSIs or blood-borne transmission of infection from double-gloving) has led to actual harm, particularly if the environmental damage and huge costs to healthcare services are taken into account. Review of the history of surgical gloves suggests that some accepted dogma should be challenged and that guidelines for glove wearing would be better aligned to the available evidence if they are to minimize harm.