Comparison of Unnoticed Glove Perforations during Minimally Invasive versus Open Surgeries: A Systematic Review and Meta-Analysis

Abstract

Objective: Various studies have depicted the incidence of glove perforations during open (OS) and minimally invasive surgeries (MIS). The aim of this meta-analysis was to compare the incidence of macroscopic and microscopic glove perforations during MIS and OS. Methods: The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Scientific databases (PubMed, Web of Science, Scopus, and EMBASE) were systematically searched for comparative studies depicting the glove perforation rates during MIS and OS. Risk ratios (RR) were calculated for both the outcomes (dichotomous) and the Mantel–Haenszel method was utilized for the estimation of pooled RR. The methodological quality assessment was performed by two independent investigators using the Downs and Black scale. The main outcomes of the study were the proportion of gloves with gross (macroscopic) perforations and the proportion of gloves with microscopic perforations. Results: Four comparative studies including a total of 1428 gloves (435 from the MIS group) were included. Pooling the data demonstrated no difference in the incidence of macroscopic glove perforations among the MIS and OS groups (RR 0.57, 95% CI 0.21 to 1.54, p = 0.27). On the other hand, the incidence of microscopic perforations was significantly higher in the OS group versus the MIS group (RR 0.72, 95% CI 0.55 to 0.95, p = 0.02). However, all the studies had a moderate risk of bias. Conclusions: When compared to OS, the macroscopic glove perforation rate during MIS showed no significant difference. The incidence of microscopic glove perforations was significantly higher during OS as compared to MIS. However, due to the moderate risk of bias of the available comparative studies, the level of evidence of these studies is limited.

Safety and Effectiveness of Triclosan-Coated Polydioxanone (PDS Plus) versus Uncoated Polydioxanone (PDS II) Sutures for Prevention of Surgical Site Infection after Hypospadias Repair in Children: A 10-Year Single Center Experience with 550 Hypospadias

“…The recent literature suggests that the perforation rate of gloves can be as high as 30%. Recent studies recommend changing surgical gloves after two hours if the procedure lasts longer than two hours [ 35 ]. In addition, prolonged hospitalization has been identified as a potentially modifiable factor for SSIs in general surgery patients [ 36 ].…”

New Insights into Cutaneous Asepsis: Synergism between Pfaffia and Rosemary Extracts

“…Regardless of the material of the glove used, glove perforations are common in the clinical setting. It has been documented that glove perforation rates during surgery can be as high as 30% [ 7 ]. Therefore, antiseptics or disinfectants play an essential role in the control of nosocomial infections, in which antisepsis of skin sites that will receive some type of invasive procedures, including surgical incisions and catheter insertions, are of great importance because of their antimicrobial action, preventing infections of deeper sites [ 8 , 9 ].…”

Cost analysis of reprocessing of gloves

“…1 Intact surgical gloves are an important barrier to transmission of infections during procedures. [2][3][4][5][6][7] Reprocessing and reuse of gloves are undertaken in hospitals in resource-limited settings to reduce the cost incurred in the procurement of single use disposable gloves and also ensure the continuous supply of gloves. [8][9][10] There is no standardized procedure to ascertain the integrity of gloves after reprocessing and visual detection or any other method routinely used is not reliable.…”