Is Single Gloving Still Acceptable? Investigation and Evaluation of Damages on Sterile Latex Gloves in General Surgery

Abstract

(1) Background: The sterile latex surgical glove is an important part of protecting both the patient and the surgical team from infections. However, mechanical stress can damage the integrity of the glove material and thus may lead to infections. (2) Method: A total of 896 gloves from 448 surgeries were tested and evaluated by the water tightening test according to EN455 and ASTM D5151-19. (3) Results: From 448 surgeries, 18.8% of the interventions showed glove damage. In vascular surgery, gloves were damaged in 20.8%, in thoracic surgery 9.1%, in laparoscopic interventions 21.7%, in the subgroup hernia surgeries (TAPP) 17.6% and in open interventions 17.6%. A total of 101 damages were found on 896 gloves; one glove could have several damages. During vascular surgery, 60% of the damages were on the subordinated hand of the surgeon, and 73.3% of the damages had a size of 1 mm. In laparoscopic procedures, the subordinated hand was also more frequently affected (61.3%) than the dominant hand; 64.5% of the damages were 1 mm in size. In the hernia surgery subgroup (TAPP), no damage was larger than 1 mm; 66.7% were in the subordinated hand area. The duration of surgery had no influence on the lesion rate. (4) Conclusion: The damage rate in low impact procedures is high and represents an underestimated problem in soft tissue surgery. The use of single gloving can therefore lead to the risk of infection. EN455 and ASTM D5151-19 does not take into consideration the risk of intraoperative lesions. Double gloving and glove change algorithms should be established.

Knot tying in arthroplasty and arthroscopy causes lesions to surgical gloves: a potential risk of infection

“…As shown in this study, surgical knot tying primarily caused microlesions. Thus, some of the lesions on gloves described in the literature could be explained, even during mechanically less demanding procedures such as soft tissue surgery [ 9 , 24 , 32 ]. As shown, surgical hand disinfection can provide an effect of germ reduction over a period of 45 min, but longer-duration surgeries could result in recurrence of pathogen formation, as alcohol-based disinfectants have a rapid germicidal effect on the skin but no lasting residual activity [ 27 , 28 ].…”

“…As a result, the integrity of the gloves is compromised [4,10,11,33]. However, glove damage was also described in previous studies during much less mechanically demanding operations, such as joint arthroscopies and laparoscopic procedures [9][10][11]22].…”