Bacterial migration through punctured surgical gloves under real surgical conditions

Abstract

BackgroundThe aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions.MethodsAn established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag method was used to retrieve organisms from the inner glove, and thus-obtained bacteria were compared with micro-organisms detected by an intra-operative swab.ResultsIn 20 consecutive procedures, 194 gloves (98 outer gloves, 96 inner gloves) were examined. The rate of micro-perforations of the outer surgical glove was 10% with a median wearing time of 100 minutes (range: 20-175 minutes). Perforations occurred in 81% on the non-dominant hand, with the index finger most frequently (25%) punctured. In six cases, bacterial migration could be demonstrated microbiologically. In 5% (5/98) of outer gloves and in 1% (1/96) of the inner gloves, bacterial migration through micro-perforations was observed. For gloves with detected micro-perforations (n = 10 outer layers), the calculated migration was 50% (n = 5). The minimum wearing time was 62 minutes, with a calculated median wearing time of 71 minutes.ConclusionsThis study confirms previous results that bacterial migration through unnoticed micro-perforations in surgical gloves does occur under real practical surgical conditions. Undetected perforation of surgical gloves occurs frequently. Bacterial migration from the patient through micro-perforations on the hand of surgeons was confirmed, limiting the protective barrier function of gloves if worn over longer periods.

Evaluation of adherence to measures for the prevention of surgical site infections by the surgical team

“…One explanation would be the increase of surgical team fatigue over time that can lead to inattention (22) . The frequent exchange of surgical gloves in longer procedures have been related to the reduction of microbial contamination rate (23)(24) , the replacement thereof being suggested during prolonged surgeries, preferably every 90 minutes (25) . The protocol of the study institution recommends that in a surgery with prosthesis implantation or duration above 3 hours the gloves should be replaced in the second hour or at different stages of the procedure, such as incision and preparation of the site of the prosthesis/implant, prosthesis placement and closure.…”

Gloves Reprocessing: Does It Really Save Money?

“…Gloves have been known to be one of the important components of PPE and, along with hand hygiene, play a significant role in the prevention of HAI. Intact surgical gloves are an important barrier for transmission of infection to and from the patients [3]. Esteban et al demonstrated the possibility of transmission of hepatitis C from surgeon to the patients due to intraoperative perforation of the gloves [4].…”

Prevention of fracture-related infection: a multidisciplinary care package

“…It should therefore be recommended to repeat the scrub or rub procedure depending on duration of the surgical procedure [75]. In addition, it must be emphasised that surgical gloves do not provide absolute protection against contaminants [76]. Especially in trauma and orthopaedic surgery, unnoticed perforations are common, with perforation rates between 3.6% and 21%.…”