A Pilot Study on the Repair of Contaminated Traumatic Wounds in the Emergency Department Using Sterile versus Non-Sterile Gloves

Abstract

Background Although the use of sterile gloves for minor and major surgical repairs is the current standard of care, use of non-sterile and clean gloves has been shown to be safe in certain procedures. In this study, we compared the infection rates of contaminated lacerations repaired with sterile versus non-sterile gloves. Materials and methods A prospective, randomised, two-centre pilot trial included patients that attended the emergency department with any type of visible contaminated soft tissue lacerations. The patients were selected according to convenience sampling technique and divided into two groups using random number table. Age, sex, and characteristics of the wound were assessed by a physician. According to that, the physician used sterile gloves or non-sterile, clean gloves for wound repair. Clinical data were analysed by chi-square test and paired-t test where appropriate. A p value =/< 0.05 was considered as statistically significant. Results Two hundred and twenty two recruited subjects with visible contaminated simple wounds were randomised to 2 groups. Males constituted 89.2% of the patients. The sites of lacerations were extremities in 50.5% of patients, head or neck in 48.4% of patients, and trunk in 1.1% of patients. Overall infection rate was 3.2%. The infection rates in the sterile gloves group and the clean gloves group were 2.02% and 4.6%, respectively (relative risk=2; odds ratio=2.3). Incidence of infection was not significantly different between two groups (p=0.322). Conclusion It seems that uses of clean gloves rather than sterile gloves do not increase the risk of infection in the repair of contaminated simple wounds in emergency department setting. (Hong Kong j. emerg.med. 2014;21:148-152)

Sterile eller rene hansker ved småkirurgi i allmennpraksis

“…I Cochrane-registeret over randomiserte, kontrollerte forsøk var det fire, fem og fire treff. Én fulltekstartikkel ble lest og inkludert (20). I OVID kunne bare de to første søkestrengene benyttes.…”

“…Til gjengjeld var alle prospektive og randomiserte. En var gjennomført i allmennpraksis i Australia (12), mens de to andre var fra legevakter, henholdsvis i Canada (14) og Iran (20). Ingen av disse viste forskjell i forekomsten av sårinfeksjon ved bruk av sterile hansker istedenfor rene.…”

“…Allmennmedisin Heal (12) RCT Negativ Moderat Perelman (14) RCT Negativ Moderat Ghafouri (20) RCT Negativ Svaert lav Andre fagområder Xia (15) RCT Negativ Svaert lav Cheung (17) RCT Negativ Svaert lav Chiu (21) RCT Negativ Svaert lav Førsteforfatter Studie Utfall Vitenskapelig kvalitet Adeyemo (18) RCT Positiv Svaert lav Giglio (19) RCT Negativ Svaert lav Rouges (22) Prospektiv observasjon Uavklart Svaert lav Alam (13) Prospektiv observasjon Positiv Lav Mehta (23) Prospektiv observasjon Negativ Svaert lav Rhinehart (16) Retrospektiv observasjon Negativ Svaert lav…”

“…Kun tre studier fra allmennmedisin ble funnet. Av disse er to publisert ganske nylig (12,20) og den siste for drøye ti år siden (14). Alle var randomiserte, kontrollerte og prospektive studier og to vurderes å ha moderat god kvalitet (12,14).…”

“…bruk av antibiotika lokalt og/eller systemisk, eller henvisning til spesialist grunnet sårinfeksjon. Definisjonen i den iranske studien gikk ikke klart frem (20). Infeksjonsfrekvensen i de tre studiene kan derfor ikke sammenlignes.…”