Incidence and patterns of surgical glove perforations: experience from Addis Ababa, Ethiopia

Abstract

BackgroundSurgical glove perforation is a common event. The operating staff is not aware of the perforation until the procedure is complete, sometimes in as high as 70% of the incidences. Data from Ethiopia indicates that the surgical workforce suffers from a very surgery related accidents, however there is paucity of data regarding surgical glove perforation.The main objective is to describe the incidence and patterns of surgical glove perforation during surgical procedures and to compare the rates between emergency and elective surgeries at one of the main hospitals in Addis Ababa Ethiopia.MethodsThis is a prospective study, performed at the Minilik II referral hospital, Addis Ababa. All surgical gloves worn during all major surgical procedures (Emergency and Elective) from June 1-July 20, 2016 were collected and used for the study. Standardised visual and hydro insufflation techniques were used to test the gloves for perforations. Parameters recorded included type of procedure performed, number of perforations, localisation of perforation and the roles of the surgical team.ResultsA total of 2634 gloves were tested, 1588 from elective and 1026 from emergency procedures. The total rate of perforation in emergency procedures was 41.4%, while perforation in elective surgeries was 30.0%. A statistically significant difference (P < 0.05) was found in between emergency and elective surgeries.There were a very high rate of perforations of gloves among first surgeons 40.6% and scrub nurses 38.8% during elective procedures and among first surgeons (60.14%), and second assistants (53.0%) during emergency surgeries.Only 0.4% of inner gloves were perforated. The left hand, the left index finger and thumb were the most commonly perforated parts of the glove. Glove perforation rate was low among consultant surgeons than residents.ConclusionsOur reported perforation rate is higher than most publications, and this shows that the surgical workforce in Ethiopia is under a clear and present threat. Measures such as double gloving seems to have effectively prevented cutaneous blood exposure and thus should become a routine for all surgical procedures. Manufacturing related defects and faults in glove quality may also be contributing factors.

Gloves puncture in general dentistry.

“…Even though wearing two fold gloves might not prevent pungent injuries, it does intensify the force required for penetration, 16,17 and could converse further protection due to "wipe off "result of dual glove layers. 18 The outcome of extant study specifies the risk of glove perforation in maxillofacial surgical procedures is considerable. The results of previous studies show that perforation rate throughout a diversity of minor dental & oral surgical procedures has vacillated from 4.1% to 16%.…”

Fingernail length as a predisposing factor for perforations of latex gloves: a simulated clinical experiment

“…Patel et al found that 0-3% of unused gloves had perforations as a result of manufacturers' defects (9). Other investigators assessed the integrity of gloves after clinical procedures and reported considerable diversity in the rate of perforations, from 1.9% (10) to 41% (15). The compromised integrity of examination and surgical gloves has been linked to a number of factors, such as: the Research article material of the glove, being latex and non-latex (i.e.…”

“…The compromised integrity of examination and surgical gloves has been linked to a number of factors, such as: the Research article material of the glove, being latex and non-latex (i.e. nitrile or vinyl) (9); concentration of latex in the glove (12); duration for which gloves were used (11,13); and the nature of clinical hand manipulation related to the clinical specialty (9,14,15). The effect of clinicians' fingernail length as a predisposing factor for latex glove perforation following clinical procedures has not been previously investigated.…”

“…For example, Patel et al found that 0-3% of unused gloves have pre-existing punctures (9), while Murray et al found that 1.95-5.3% of gloves had defects following routine dental practice (10). The integrity of gloves as a physical barrier has been linked to a number of factors, such as the material of the gloves and their latex content, as well as the duration and nature of the clinical procedures (10)(11)(12)(13)(14)(15). The role of fingernails in compromising glove integrity has not been previously assessed.…”

Reducing Surgical Site Infections During Otolaryngology Surgical Missions

“…They attributed this to the poor‐quality gloves purchased by the hospital. Given these concerns, teams should consider transporting a supply of high‐quality surgical gloves for use on short‐term missions. Double‐gloving may be more important when glove quality is questionable and rates of communicable disease are high.…”