Investigation of Incidence and Risk Factors for Surgical Glove Perforation in Small Animal Surgery

Hayes, Galina; Reynolds, Debbie; Moens, Noël M. M.; Singh, Ameet; Oblak, Michelle L.; Gibson, Thomas W.G.; Brisson, Brigitte A.; Nazarali, Alim; Dewey, Cate

doi:10.1111/j.1532-950x.2014.12159.x

Cited by 22 publications

(58 citation statements)

References 22 publications

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“…However, the frequency of perforations in our orthopedic and open soft tissue surgery (33–39%) were higher. These procedures were significantly more likely (3 times) to have glove perforations than minimally invasive surgery, in agreement with previous studies stating that increased invasiveness (open procedures) and sharp orthopedic equipment increases the risk of glove perforations …”

Section: Discussionsupporting

confidence: 91%

“…This study reports the frequency of undetected glove perforations in equine surgery. The overall 27% frequency, with a 95% confidence interval of 22–33% captures the estimates of 22 and 26% from small animal surgery, as hypothesized . However, the frequency of perforations in our orthopedic and open soft tissue surgery (33–39%) were higher.…”

Section: Discussionsupporting

confidence: 69%

“…Two recent veterinary studies in small animal hospitals used the water leak test to detect glove perforations (500 and 600 mL of water per glove—water leak test ASTM D5151) . At least 1 glove perforation occurred in 22 16 and 26%of surgeries.…”

mentioning

confidence: 99%

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Frequency of Undetected Glove Perforation and Associated Risk Factors in Equine Surgery

et al. 2016

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 69%

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Frequency of Undetected Glove Perforation and Associated Risk Factors in Equine Surgery

et al. 2016

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“…The overall incidence of postoperative glove perforations in our study was 18%. This is within the range of the incidence reported in other veterinary studies (10.2–26.2%) . These studies reported a similar increased risk for punctures in the nondominant hand, on gloves worn by the primary surgeon, and in surgeries of longer duration.…”

Section: Discussionsupporting

confidence: 87%

“…Surgeon‐based intraoperative glove contamination may be a result of glove puncture and bacterial migration from the surgeon's hand to the glove surface. The frequency of intraoperative glove puncture in veterinary medicine ranges from 10.2–26.2% …”

mentioning

confidence: 99%

Survey of Intraoperative Bacterial Contamination in Dogs Undergoing Elective Orthopedic Surgery

Andrade¹,

Schmiedt²,

Cornell³

et al. 2016

Veterinary Surgery

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Objective: To investigate the frequency, source, and risk factors of intraoperative (IO) surgeon and patient bacterial contamination during clean orthopedic surgeries, and to investigate the relationship between IO contamination and surgical site infection (SSI) in dogs. Study Design: Prospective clinical study. Sample Population: Client-owned dogs undergoing stifle surgery (n ¼ 100). Methods: IO cultures were taken in each case from surgical foot wrap, peri-incisional skin, surgical gloves, and the surgical team's hands. The environment (operating room [OR] lights, computers, scrub sink faucet, anesthesia gurney, and radiology table) was sampled every 5 months. Bacteria were identified and the contamination of each case was categorized. All gloves from the surgical team were collected and tested for perforations using a water infusion test. Cases were followed for at least 8 weeks to determine the presence or absence of SSI. Perioperative variables were evaluated for association with IO contamination and SSI. Results: Bacterial isolates were yielded from 81% of procedures from 1 or more sources; 58% had positive hand cultures, 46% had positive glove cultures, 23% had positive patient skin cultures, and 12% had positive foot wrap cultures. Staphylococcus spp. was the most commonly recovered bacteria. There was no apparent association between IO contamination and SSI. The highest level of environmental contamination was associated with the scrub sink faucet, followed by the radiology table, anesthesia gurney, and OR computers. The IO glove perforation rate was 18%. Conclusion: Clean orthopedic procedures commonly had clinically insignificant bacterial contamination. In our study, bacteria responsible for SSI did not appear to colonize the patient in the OR. In the veterinary literature, surgical site infection (SSI) rates for patients undergoing clean surgical procedures range from 3.6-5.8%. 1-3 Infection occurs despite adherence to well-accepted standards of surgical technique and environmental control designed to maintain a sterile surgical field. 4 Little objective information is available to validate how successfully these techniques control intraoperative contamination of surgical gloves, patient wraps, patient skin, and surgeon skin. In addition, it is not known how bacteria associated with surgical procedures influence complications. Understanding the bacterial ecology of veterinary operating rooms during the intraoperative period is critical in the search for the source of SSI, and allows for the development of evidence-based strategies to control the impact of pathogenic microbes in the surgical environment. In human surgical practice, published intraoperative glove contamination rates range from 14-56%. 5,6 Studies have not reported a clear primary source of contamination. One study reported surgical personnel, followed by the patient, and operating room environment as the most common sources of contamination 7 ; however, another study reported the operating room environment as the major source, followe...

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Management Practices that Influence Wound Infection and Healing

Dart¹,

Sole‐Guitart²,

Stashak³

et al. 2016

Equine Wound Management

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Investigation of Incidence and Risk Factors for Surgical Glove Perforation in Small Animal Surgery

Abstract: There is a high incidence of unrecognized glove perforations in small animal surgery.

Cited by 22 publications

References 22 publications

Frequency of Undetected Glove Perforation and Associated Risk Factors in Equine Surgery

Frequency of Undetected Glove Perforation and Associated Risk Factors in Equine Surgery

Survey of Intraoperative Bacterial Contamination in Dogs Undergoing Elective Orthopedic Surgery

Management Practices that Influence Wound Infection and Healing

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