Incidencia de la perforación de los guantes en cirugía y efecto protector del doble guante / Glove perforation in surgery and protective effect of double gloves

Objetivo. Estudiar la incidencia de perforaciones en los guantes en cirugía programada comparando la proporción de punciones entre el guante simple y el doble guante. Evaluar la proporción de estas punciones que permanecen inadvertidas. Método. Ensayo clínico, aleatorizado y controlado de un año de duración realizado en 2008 durante las cirugías programadas en los quirófanos del Hospital Universitario de Canarias. Se estudiaron los guantes simples y dobles (interno y externo), llevados por cirujanos, ayudantes y enfermeras instrumentistas. Los guantes se midieron durante 3min con el método estandarizado de «Fuga de Agua» (EN455-1) al finalizar la cirugía para detectar fugas. Resultados. En 113 cirugías se evaluaron 1.537 guantes, ocurriendo 7 perforaciones advertidas y 104 inadvertidas, la mayor parte en cirugías mayores. De las punciones inadvertidas, 43 (41,3%) ocurrieron en guantes simples, 51 (49%) en guantes exteriores del doble enguantado y 10 (9,6%) en los guantes internos. La proporción de perforación de los guantes en los cirujanos 9,85%, resultó ligeramente mayor que en las enfermeras 6,91%, pero significativamente mayor que en los ayudantes 4,04% (p<0,001). Conclusiones. Se concluye que el doble guante es efectivo en cirugía pues la barrera protectora es mantenida por el guante interno en cuatro de cada cinco casos en que el guante externo es perforado inadvertidamente. A pesar de la posible incomodidad y reducción de sensibilidad, debe tenerse en cuenta la efectividad del enguantado doble como barrera protectora(AU)

Objective. To investigate the incidence of glove perforation in programmed surgery and compare perforation rates between single-gloves and double-gloves. To evaluate the extent to which glove perforations remain undetected during surgery. Method. Randomized and controlled trial. A one year of study period in 2008 consisting of programmed surgeries at the Canary Islands University Hospital. Gloves, randomized into single or double, worn by surgeons, assistants and scrub nurses were analyzed using the Water Leak Test (EN455-1) for 3min after surgery ended to detect leakage. Results. A total of 1537 gloves were examined during 113 operations, 7 perforations were noticed during the operation and 104 unnoticed, especially in mayor surgery. Of these, 43 perforations (41.3%) occurred while wearing single gloves and 51 (49%) in the outer of a double glove. Only 10 perforations (9.6%) were found in the inner glove. The perforation rate for surgeons was 9.85%, were slightly greater than nurses at 6,91%, but significantly greater that the rate for assistants, 4,04% (p<0.001). Conclusions. We conclude that double gloving is effective in surgery, in as much as the barrier protection was maintained by the inner glove in four out of five cases when the outer glove was inadvertently perforated. Surgical teams must balance the improved safety of double gloving with the possible discomfort and reduced sensitivity (AU)

[Glove perforation in surgery and protective effect of double gloves]. / Incidencia de la perforación de los guantes en cirugía y efecto protector del doble guante.

OBJECTIVE: To investigate the incidence of glove perforation in programmed surgery and compare perforation rates between single-gloves and double-gloves. To evaluate the extent to which glove perforations remain undetected during surgery. METHOD: Randomized and controlled trial. A one year of study period in 2008 consisting of programmed surgeries at the Canary Islands University Hospital. Gloves, randomized into single or double, worn by surgeons, assistants and scrub nurses were analyzed using the Water Leak Test (EN455-1) for 3 min after surgery ended to detect leakage. RESULTS: A total of 1537 gloves were examined during 113 operations, 7 perforations were noticed during the operation and 104 unnoticed, especially in mayor surgery. Of these, 43 perforations (41.3%) occurred while wearing single gloves and 51 (49%) in the outer of a double glove. Only 10 perforations (9.6%) were found in the inner glove. The perforation rate for surgeons was 9.85%, were slightly greater than nurses at 6,91%, but significantly greater that the rate for assistants, 4,04% (p<0.001). CONCLUSIONS: We conclude that double gloving is effective in surgery, inasmuch as the barrier protection was maintained by the inner glove in four out of five cases when the outer glove was inadvertently perforated. Surgical teams must balance the improved safety of double gloving with the possible discomfort and reduced sensitivity.