Surgeons’ and residents’ double-gloving practices at 2 teaching hospitals in Ontario

Abstract

Background: Surgeons and residents are at increased risk of exposure to blood-borne pathogens owing to percutaneous injury (PI) and contamination. One method known to reduce risk is double-gloving (DG) during surgery.Methods: All surgeons and residents affiliated with the University of Western Ontario (UWO) and McMaster University in 2005 were asked to participate in a Web-based survey. The survey asked respondents their specialty, the number of operations they participated in per week, their age and sex, the proportion of surgeries in which they double-gloved (DG in ≥ 75% surgeries was considered to be routine), and the average number of PIs they sustained per year and whether or not they reported them to an employee health service. Results:In total, 155 of 331 (47%) eligible surgeons and residents responded; response rates for UWO and McMaster surgeons were 50% and 39%, respectively, and for UWO and McMaster residents, they were 52% and 47%, respectively. A total of 43% of surgeons and residents reported routine DG; 50% from McMaster and 36% from UWO. Using logistic regression to simultaneously adjust for participant characteristics, we confirmed that DG was more frequent at McMaster than at UWO, with an odds ratio of 3.32 (95% confidence interval 1. 35-8.17). Surgeons and residents reported an average of 3.3 surgical PIs per year (2.2 among McMaster participants and 4.5 among UWO participants). Of the 77% who reported at least 1 injury/year, 67% stated that they had not reported it to an employee health service. Conclusion:Percutaneous injuries occur frequently during surgery, yet routine DG, an effective means of reducing risk, was carried out by less than half of the surgeons and residents participating in this study. This highlights the need for a more concerted and broad-based approach to increase the use of a measure that is effective, inexpensive and easily carried out.

Practice and attitudes regarding double gloving among staff surgeons and surgical trainees

“…The proportion of all respondents who reported that they double glove routinely, 52%, is similar to that observed in previous studies, 1,2 whereas the proportion who reported ever double gloving, 78%, is higher. 1,2 In a large study (n = 509) conducted in Toronto and published over 20 years ago, Wright and colleagues 5 reported lower rates of routine double gloving (23.3%) and use of protective eyewear (66.4%) than those observed in the current study. The higher rates of double gloving in our study likely reflect increased concern for the personal safety of the surgical team and improved adherence to safety behaviours and best safety practices.…”

“…2 A 2011 study from Ontario also showed low rates of compliance with this safety practice. 1 Similar studies in other jurisdictions revealed low rates of double gloving. [3][4][5] The low level of double gloving is inconsistent with evidence supporting this practice.…”

“…Despite evidence supporting double gloving in the operating room, the literature suggests that many staff surgeons and surgical trainees do not routinely double glove. 1 Previous studies showed slow adoption of double gloving by staff surgeons and surgical trainees in Canada. A 2003 survey in the Capital Health Region and University of Alberta, Edmonton, showed that most staff surgeons and surgical trainees did not routinely double glove.…”

High Risk of Surgical Glove Perforation From Surgical Rotatory Instruments

“…With more specimens, more detailed analysis of risk by glove type and other factors could be possible. Double gloving is an effective way to protect patients and practitioners and is common practice in our institution; however, double gloving, while common, is not universally practiced [7,13,18]. Mischke et al [13] found inner-glove puncture risk could be reduced by 71% with double gloving.…”

“…The use of power tools, handling sharp bone, and working in deep cavities all influence the risk of glove perforations in orthopaedic surgery [20]. Double gloving has been recommended in orthopaedic procedures to ameliorate the risk of perforation but compliance is not universal [7,18]. Duration of wear, degree of soilage, and other risk factors for glove perforation also have been reported [2,16].…”