Surgical Glove Perforations During Surgical Operations: an Ever Existing Risk in the Theatre

ABSTRACT

Background:The use of surgical gloves as a protective barrier between the surgeon and the patient has been the accepted standard. The prevalence of intraoperative glove perforations is high and often not recognized. Perforations may increase the potential for wound sepsis and for accidental exposure of the surgeon and the patient to human immunodeficiency virus (HIV) and hepatitis B virus.Aim: To investigate the incidence of glove perforations during surgery and to evaluate the extent to which glove perforations remain undetected during surgery. Methods: A prospective study in which a total of 2541 gloves used to perform surgical operations on 210 patients within a period of 12 months (January - December; 2009) were analyzed for perforations. These gloves were worn by the surgeons and scrub nurse and were double gloves. Twenty five unused gloves were used as control. The operations were all for general surgical cases. All gloves were tested for perforations by a simple water inflation technique at the end of each procedure. Results: By this water inflation technique; 225 gloves (8.9) were observed to have had perforations. Twenty one gloves (9.3) were noticed to have perforated in course of the surgery while 204 (90.7) were unnoticed. None of the unused gloves showed any perforation. There was an obvious difference in the perforate rate between the inner and outer gloves. It was 13.7for inner gloves as against 88.3for outer gloves.Conclusion: The incidence of surgical glove perforations is unacceptably high. The risk of transmission of diseases between surgeon/patient remains present. Protective measures like double gloving; the use of blunt needles; needle puncture resistance surgical gloves; glove liners and finger guards should be introduced in hospitals