Prevalence and associated factors of surgical gloves perforation in elective orthopaedic and trauma surgeries done at KCMC, from November 2018 through May 2019; Prospective observational study

Abstract

Background: Since medical history and examination can't reliably identify all patient harbouring bloodborne pathogens, universal precautions during exposure to blood and body fluid are now imperative. Intact surgical glove is an integral part aimed to protect patients from the surgical team members' microbial flora of the hand and mutually, surgical team members from pathogens of the patient's body, nevertheless surgical glove perforation is a major concern with a perforation rate as high as 50% has been reported in literature depending on the type of surgery. The risk of perforation is thought to correlates with many factors, yet very few prospective studies have addressed this issue at Kilimanjaro Christian Medical centre Hospital. Objective: The intent of this study was to determine the prevalence and associated factors of surgical gloves perforation in elective orthopaedic and Trauma surgeries. Methods: Prospective observational study design was conducted at Orthopaedics and Trauma operating theatres. Systematic sampling technique was used, after surgery inner and outer surgical gloves utilized by the surgical team were collected, labelled and tested by water leak test method (EN 455-1) consisting of visual evaluation of gloves after hydro insufflation. Results; Total of 1672 surgical gloves were collected during the study period, overall perforations were found to be 17.1%, higher perforation seen in bone surgeries. Among the surgical team members, the highest perforation was seen in surgeons 49.7% with much involvement of index finger 36.9% followed by the thumb 21.1% in the non-dominant hand. Surgeries lasting longer than 90 minutes found to associate with a high proportion of surgical glove perforation. Conclusion; Our results portray that there is a significant relationship between the type of surgery, the role of surgical a team member, the dominance of the hand, glove layer and the location of perforation with the prevalence of surgical glove perforation.