Glove punctures in an orthopaedic trauma unit

Eckersley, J. R. T.; Williamson, Dianne

doi:10.1016/0020-1383(90)90090-h

Cited by 32 publications

(19 citation statements)

References 4 publications

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“…In their study, perforation was observed in 15.4% of gloves during the first 90 minutes of orthopaedic procedures and this increased to 18.1% if the glove was worn between 91 to 150 minutes, and to 23.7% if the glove was worn longer than 150 minutes [16]. Limited data are available regarding risk of compromise of glove integrity in specific orthopaedic procedures [1,2,4,6,8,9,20]. At least one glove was found to be perforated in 39% of TKAs, with a perforation incidence of 4.29% of the gloves worn in these procedures [8].…”

Section: Discussionmentioning

confidence: 99%

“…An in vitro control group was considered; however, given the changes in glove properties with time with wear and presence of biologic material, it was not deemed appropriate. An in vivo control also was considered; however, given the known percentages of glove perforations reported in prior studies [2,[4][5][6] a control group was deemed unnecessary.…”

Section: Discussionmentioning

confidence: 99%

“…The mechanism of contamination was not reported in that study. Likewise in orthopaedic trauma, Eckersley and Williamson [6] found that a single glove may be perforated more than 50% of the time during the course of internal fixation of a fracture and this rate was reduced to 17% with double gloving. Our study suggests that entanglement in rotatory tools is a mechanism in which perforations have a greater likelihood of occurrence.…”

Section: Discussionmentioning

confidence: 99%

“…Our study suggests that entanglement in rotatory tools is a mechanism in which perforations have a greater likelihood of occurrence. Few studies have evaluated the specific mechanisms in which glove perforations occur, except needle sticks [4][5][6]9]. Chan et al [5] showed that perforations are caused by instrumentation in 45% of all glove perforations, versus only 20% by bone debris, 15% by surgical knots, and only 5% are attributable to scalpel blades or pins each.…”

Section: Discussionmentioning

confidence: 99%

“…Level of Evidence Level IV, therapeutic study. [1,2,6]. Perforations can increase the risk of surgical-site infection, and expose the surgeon to blood-borne diseases such as HIV, hepatitis C virus, and hepatitis B virus [10,14].…”

Section: Introductionmentioning

confidence: 99%

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High Risk of Surgical Glove Perforation From Surgical Rotatory Instruments

Goldman

Haug

Owen

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Surgical gloves can be damaged during the course of a procedure, which can place the surgeon and patient at risk. Glove perforation may not always be readily apparent, and determining the risk factors for glove perforation can aid the surgeon in deciding when a glove change is advisable. Time of wear and needle sticks have been well studied; however, other mechanisms including mechanical stress from surgical equipment have had limited evaluation to date. Questions/purposes We evaluated the risk of glove perforation in gloves that were caught in a surgical rotatory device (such as drills and reamers). The aims of our study were (1) to determine the percentage of undetected microperforations after entanglement on a rotatory tool during orthopaedic procedures, (2) to determine which kinds of rotatory devices most commonly cause such microperforations, and (3) to assess whether time of wear had an effect on the risk of perforation. Methods From July 2014 to September 2015, 33 gloves were obtained from all orthopaedic subspecialties at our Level I trauma center if they were caught in a rotatory device greater than one revolution. Time of glove wear and location of the glove that was caught in a rotatory device were recorded. After an evaluation for macroperforations (C 5 mm), the gloves were evaluated for microperforations (\ 5 mm) via the American Society for Testing and Materials (ASTM) one-liter load test. Time of wear was compared among gloves with macroperforations, microperforations, and no perforations. Results The 33 gloves obtained came from 33 procedures. Seventeen of 33 (52 %) gloves had perforations. Seven of the 17 perforated gloves had macroperforations while 10 had microperforations. Eleven of 33 entanglements were caught by drills, nine by reamers, eight by Kwires, and the remaining five gloves were caught by various other instruments. Eight of 17 perforations were caused by drills, three by reamers, three by K-wires, and three by various other instruments. The average time of wear was 58 minutes which did not differ with pattern of glove damage.

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