Intraoperative damage to surgical gloves during various operations on the musculoskeletal system: a multicenter study

Enz, Andreas; Kostuj, Tanja; Warnke, Philipp; Osmanski-Zenk, Katrin; Mittelmeier, Wolfram; Klinder, Annett

doi:10.1007/s00402-020-03594-1

Cited by 3 publications

(7 citation statements)

References 25 publications

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“…This result is broadly consistent with other studies that have examined surgery time and damage rate [33]. In contrast, especially with mechanically demanding interventions, such as hip or knee endoprostheses or endoprosthetic revision procedures, it was shown that over time, due to accumulation of stress factors, mechanical damage increases in the course of the surgery [14,15]. However, the surgery duration of the majority of surgeries in this study was shorter than the threshold of 90 min, after which a glove exchange is recommended [14].…”

Section: Lesion Rate and Surgery Durationsupporting

confidence: 89%

“…The localization of the damage is consistent with the published data on arthroscopic interventions, where the subordinate hand was also primarily affected [8]. When examining the data on laparoscopy in this study as well as on arthroscopy from a previous study [15], the thumb of the subordinate hand was particularly susceptible to damage in both of the procedures. In these minimally-invasive procedures, instruments and techniques used could be the deciding factor.…”

Section: Tear Locations On Glovessupporting

confidence: 87%

“…There are only limited data in the literature regarding the location of tears in gloves during soft tissue surgery. In orthopaedic and trauma surgeries such as total joint arthroplasty or internal fixation of bone fractures, lesions were primarily described in the area of the index finger of the dominant hand [15,29,30]. In the presented study most of the damage occurred at the subordinate hand during soft tissue surgical procedures.…”

Section: Tear Locations On Glovesmentioning

confidence: 85%

“…The susceptibility to intraoperative damage during soft tissue surgery has been poorly investigated up to the present. In contrast, some studies of orthopaedic surgery have given rise to disturbing results [15,16].…”

Section: Discussionmentioning

confidence: 99%

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Is Single Gloving Still Acceptable? Investigation and Evaluation of Damages on Sterile Latex Gloves in General Surgery

Enz

Kamaleddine

Groß

et al. 2021

JCM

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(1) Background: The sterile latex surgical glove is an important part of protecting both the patient and the surgical team from infections. However, mechanical stress can damage the integrity of the glove material and thus may lead to infections. (2) Method: A total of 896 gloves from 448 surgeries were tested and evaluated by the water tightening test according to EN455 and ASTM D5151-19. (3) Results: From 448 surgeries, 18.8% of the interventions showed glove damage. In vascular surgery, gloves were damaged in 20.8%, in thoracic surgery 9.1%, in laparoscopic interventions 21.7%, in the subgroup hernia surgeries (TAPP) 17.6% and in open interventions 17.6%. A total of 101 damages were found on 896 gloves; one glove could have several damages. During vascular surgery, 60% of the damages were on the subordinated hand of the surgeon, and 73.3% of the damages had a size of 1 mm. In laparoscopic procedures, the subordinated hand was also more frequently affected (61.3%) than the dominant hand; 64.5% of the damages were 1 mm in size. In the hernia surgery subgroup (TAPP), no damage was larger than 1 mm; 66.7% were in the subordinated hand area. The duration of surgery had no influence on the lesion rate. (4) Conclusion: The damage rate in low impact procedures is high and represents an underestimated problem in soft tissue surgery. The use of single gloving can therefore lead to the risk of infection. EN455 and ASTM D5151-19 does not take into consideration the risk of intraoperative lesions. Double gloving and glove change algorithms should be established.

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Section: Lesion Rate and Surgery Durationsupporting

confidence: 89%

Section: Tear Locations On Glovessupporting

confidence: 87%

Section: Tear Locations On Glovesmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Is Single Gloving Still Acceptable? Investigation and Evaluation of Damages on Sterile Latex Gloves in General Surgery

Enz

Kamaleddine

Groß

et al. 2021

JCM

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“…Recent studies have shown high rates of glove damage in joint and revision arthroplasty, procedures where gloves are subjected to repetitive mechanical stress during surgery. As a result, the integrity of the gloves is compromised [ 4 , 10 , 11 , 33 ]. However, glove damage was also described in previous studies during much less mechanically demanding operations, such as joint arthroscopies and laparoscopic procedures [ 9 – 11 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Knot tying in arthroplasty and arthroscopy causes lesions to surgical gloves: a potential risk of infection

Enz

Klinder

Bisping

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose Recent studies have shown that the incidence of glove lesions during arthroscopy is much lower than that during primary and revision arthroplasty. However, the rate of glove damage after knot tying has not yet been systematically recorded. Therefore, the aim of the study was to determine the impact of surgical knot tying on glove integrity. It was hypothesized that knot tying increases the rate of glove damage, especially in arthroscopic surgery, which could be of special relevance in the treatment of rotator cuff tears. Methods Gloves that were changed immediately before suturing and only worn during knot tying were investigated for their integrity by means of water tightening test according to EN455. A total of 234 gloves from 40 total hip arthroplasties (THAs), 42 total knee arthroplasties (TKAs) and 36 rotator cuff repairs (RCRs) were collected. A bacterial pass-through test (BPTT) on glove lesions was performed under simulated sterile surgical conditions for 3 surgeons after a wear duration of 45 min. Results Glove damage by knot tying occurred in 25% of THA, 36.6% of TKA and 25% of RCR surgeries. In THA, the pulling hand (PH) was affected in 46.2%, and the main area of damage (15.4%) was detected on the tip of the middle finger; in TKAs the PH was damaged in 75%, and in RCRs the PH was affected in 66.7%, with most of the lesions (20% each) occurring on the tip of the index finger and the ring finger. The BPTT showed Staphylococcus hominis and Bacillus cereus. Conclusion Intraoperative knot tying causes damage to gloves, which is of special relevance for arthroscopic surgery. Whereas knot tying is only partly responsible for glove damage in arthroplasty, the general rate of glove damage in arthroscopic surgery is low without knot tying. The surgical knot tying process must be understood as a possible damaging impact on the glove. Therefore, single gloving is not recommended, which is especially important in arthroscopic surgery, where double gloving is not yet standard. Level of Evidence IV.

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Effectiveness of Double-Gloving Method on Prevention of Surgical Glove Perforations and Blood Contamination: A Prospective Study

H Chavda,

Mudgal

2024

Asian J Pharm Clin Res

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Objectives: To evaluate efficacy of double gloving to provide mechanical barrier against communicable diseases and also to evaluate different parameters affecting glove perforation rate. Methods: This prospective study was performed in department of General Surgery at tertiary care teaching hospital of Gujarat. This study involved a group of surgeons and operation theatre nursing staff. Randomization of the participants was done with the closed envelope method in two groups: single gloving and double gloving. Glove perforation rate and hand contamination rate was calculated and compared between both the groups. Participants of double gloving groups were also asked for discomfort using double gloves and compromised tactile sensations. Results: There was no statistically significant difference in the glove perforation rate between single gloves and double outer gloves. (p=0.55) But, the glove perforation rate was significantly low in double inner gloves than single gloves. (p=0.004) The hand contamination rate was significantly lower amongst perforated double gloves than perforated single gloves. (p=0.00001) Awareness of glove perforation was absent in majority of the participants in both the groups. All the participants in the double gloving group were comfortable with using double gloves and their tactile sensations were not compromised. Conclusion: This study concluded that double gloving efficiently prevented hand contaminations during a surgery. There was no significant difference noted in glove perforation rates in both single and double gloving groups. Double gloving is recommended for the surgeons and nursing staff to protect them from blood borne infections and eliminate the chances of surgical site infections in the patients.

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Intraoperative damage to surgical gloves during various operations on the musculoskeletal system: a multicenter study

Cited by 3 publications

References 25 publications

Is Single Gloving Still Acceptable? Investigation and Evaluation of Damages on Sterile Latex Gloves in General Surgery

Is Single Gloving Still Acceptable? Investigation and Evaluation of Damages on Sterile Latex Gloves in General Surgery

Knot tying in arthroplasty and arthroscopy causes lesions to surgical gloves: a potential risk of infection

Effectiveness of Double-Gloving Method on Prevention of Surgical Glove Perforations and Blood Contamination: A Prospective Study

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