Observational study on the occurrence of surgical glove perforation and associated risk factors in large animal surgery

Abstract

Incidence of glove perforation is similar in large animal, human, and small animal surgery and is influenced by duration of wear, invasiveness of the surgery, and role of the wearer. ECT is more sensitive than WLT for detection of glove perforation.

Incidence and risk factors for surgical glove perforation in small animal ophthalmic surgery

“…A total of 2000 gloves (1000 pairs) were collected between June 2017 and November 2018 following 765 ophthalmic procedures performed at three referral hospitals in the UK (Eye Vet Clinic, Leominster; The Royal Veterinary College, London; Dick White Referrals, Six Mile Bottom). The standard WLT described by the American Society of Testing and Materials 28 is the test most widely reported in the literature [12][13][14]16,[18][19][20] to estimate the incidence of perforation in surgical gloves and relies on the pressure applied by 1000mL of water inside the glove to detect perforations. The standard WLT was modified by Prendiville et al and Hayes et al 13,18 (500 mL of water) and this was the method used for the current study.…”

“…12,13 Among the risk factors described in veterinary studies as contributing to surgical glove perforation, the type and the duration of the procedure were the two most commonly identified. [12][13][14][15][16] In ophthalmic surgery in humans, the reported rate of glove perforation ranged from 0.3% to 21%. [17][18][19] A recent study among nurses scrubbed as assistant for the surgeon during ophthalmic surgery in humans, reported a rate of glove perforation of 4%.…”

“…20 To date, the occurrence of glove perforation in veterinary ophthalmic surgeries has not been reported. Several methods have been described in the published literature to test the integrity of surgical gloves, including observation of skin wetness after submersing a gloved hand under water 11,21 ; water inflation of the glove (water leak test) with [16][17][18] or without [12][13][14][15] external compression; air inflation-water submersion with 19 or without 22,23 external compression; use of water-soluble dyes to allow easier identification of perforations such as fluorescein 23,24 or methylene blue 25 ; and electrical conductance methods. 14,26,27 The aim of this study was to elucidate the incidence of glove perforation in small animal ophthalmic surgery using a water leak test (WLT) modified by previous authors, 13,18 and to explore potential risk factors.…”

Prevention and surveillance of surgical infections: A review

“…In cattle, SSI risk has also been shown to increase with increasing wound contamination (with the lowest incidence associated with clean and the highest reported for dirty wounds) . In addition, the odds of a glove perforation have been shown to increase with surgical time as well as with the invasiveness of the procedure . Although glove perforations tend to occur more commonly in the nondominant hand, there appears to be no difference with regard to surgeon experience (board‐certified vs resident) …”

“…Glove use not only is an important component of hand hygiene but is also of particular importance to surgical asepsis. Surgical glove failures are relatively common, although they are typically unrecognized by the wearer . To reduce the likelihood of a glove failure during a surgical procedure, surgeons often double glove or use reinforced gloves, particularly during orthopedic procedures.…”