Surgical glove perforation

Dodds, Richard; Guy, Pierre; Peacock, A; Duffy, S R; Barker, S. G. E.; Thomas, Melanie

doi:10.1002/bjs.1800751009

Cited by 139 publications

(61 citation statements)

References 14 publications

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“…These results are quite similar to the other studies in which chances of infection due to manual handling of shunt system have been observed up to 12 to 20%. 9, 13,14,27,30 Exposure of Shunt System to the surgical Instruments It is also evident from our results thatdue to increase touching of the shunt system can be a source of higher risk of infection. Moreover exposure of shunt system to surgical instrument can also cause infection in children.…”

Section: Manual Handling Of Shunt Systemsupporting

confidence: 55%

CSF Shunt Infection; Peadriatic Cerebrospinal Fluid Shunt Infection. Analysis of Risk Factors Instigating

Anwer

Waqas

Khan

2017

TPMJ

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ABSTRACT… Hydrocephalus is the abnormal accumulation of CSF with in the ventricles and subarachnoid spaces. It is often associated with dilatation of ventricular system and increased ICP. Hydrocephalus is almost always a result of an interruption of CSF flow and rarely because of increased CSF production. The definitive treatment of hydrocephalus is surgical treatment which includes shunting and non-shunting procedures. The most common and overwhelming complications that can occur due to the CSF shunts is infection. The risk factors associated with pediatric CSF shunt infection has been analyzed in this study. Study Design: Descriptive study. Setting: Department of Neurosurgery, Nishtar Hospital Multan & Sheikh Zayed Hospital Rahim Yar Khan. Period: Three years 01-07-2013 to 01-07-2016. Method: Total 209 eligible patients who were operated for CSF shunt were keenly monitored. Several variables were observed and the responses against these variables were noted down. Post operative follow up of all these cases done for 6 months in order to notice any development of infection (clinical signs of infection & CSF examination) in CSF shunt system. Chi-square method was used applied in order to analyze the association among the variables and shunt infection development.In our population of 209 patients only twenty six patients (12.44%) suffered from shunt infection. In this study four variables were qualified as having significant association with greater risk of shunt infection. 1) Patient age. 2) Inadvertently exposure of surgical instruments to the shunt system. 3) the existence of large number of previous shunt systems. 4) manual handling of shunt system Conclusions: Four variables have been reported by this study which can be a great source of shunt infection.it is recommended that changes in clinical practice should be considered in order to avoid these. Few recommendations are as follows. 1) While handling the shunt system great care should be taken. 2) It should be taken care that the manual contact of the Surgeons with the shunt system should be minimum. 3) it is recommended that the alternatives other then the shunt insertion should be considered especially for the children. 4) Great number of previous shunt system is also a great risk factor and these patients must be handled as individuals at high risk. Key words:Cerebrospinal fluid shunt; Infection; Hydrocephalus; Neurosurgery; Children INTRODUCTIONLike other numerous diseases of childhood such as spina bifida, brain tumors, brain hemorrhage, head injury and meningitis Hydrocephalus is also one of the childhood conditions which require insertion of cerebrospinal fluid shunt. But these CSF shunt often associated with different complications. The common complication in these CSF shunts are 3 to 15 % infection rate andmore than 40 % of two year failure rate.

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Section: Manual Handling Of Shunt Systemsupporting

confidence: 55%

CSF Shunt Infection; Peadriatic Cerebrospinal Fluid Shunt Infection. Analysis of Risk Factors Instigating

Anwer

Waqas

Khan

2017

TPMJ

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“…1,2 The rate of glove perforation has been investigated in various surgical specialities: 10% for open lung surgery, 3 12-24% for caesarean section, 4,5 28% for major gynaecological surgery, 5 26% for orthopaedic surgery 6 and 35% for general surgery. 7 Unnoticed glove perforations represent a potential risk of infection for the surgeon by prolonged exposure to blood or other body fluids. Surgeons tend to underestimate the risk of cross-infection during surgical procedures.…”

Section: Introductionmentioning

confidence: 99%

Glove perforations during open surgery for gynaecological malignancies

Manjunath

Shepherd

Barton

et al. 2008

BJOG

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Objective To audit glove perforations at laparotomies for gynaecological cancers.Setting Gynaecological oncology unit, cancer centre, London.Design Prospective audit.Sample Twenty-nine laparotomies for gynaecological cancers over 3 months.Methods Gloves used during laparotomies for gynaecological cancer were tested for perforations by the air inflation and water immersion technique. Parameters recorded were: type of procedure, localisation of perforation, type of gloves, seniority of surgeon, operation time and awareness of perforations.Main outcome measure Glove perforation rate.Results Perforations were found in gloves from 27/29 (93%) laparotomies. The perforation rate was 61/462 (13%) per glove. The perforation rate was three times higher when the duration of surgery was more than 5 hours. The perforation rate was 63% for primary surgeons, 54.5% for first assistant, 4.7% for second assistant and 40.5% for scrub nurses. Clinical fellows were at highest risk of injury (94%). Two-thirds of perforations were on the index finger or thumb. The glove on the nondominant hand had perforations in 54% of cases. In 50% of cases, the participants were not aware of the perforations. There were less inner glove perforations in double gloves compared with single gloves (5/139 versus 26/154; P = 0.0004, OR = 5.4, 95% CI 1.9-16.7). The indicator glove system failed to identify holes in 44% of cases.Conclusions Glove perforations were found in most (93%) laparotomies for gynaecological malignancies. They are most common among clinical fellows, are often unnoticed and often not detected by the indicator glove system.

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“…The evidence regarding glove perforation risks to the patient's wound has been conflicting. Dodds and colleagues [5] have suggested that glove perforations pose a limited threat for surgical site infections due to the current emphasis on improved preoperative hand preparation. By contrast, Misteli and colleagues [9] concluded that surgical glove perforations were a risk factor for surgical site infection and recommended extended antibiotic prophylaxis as a precaution.…”

Section: Where Do We Need To Go?mentioning

confidence: 99%

CORR Insights®: High Risk of Surgical Glove Perforation From Surgical Rotatory Instruments

Lindsey

2016

Clinical Orthopaedics &Amp; Related Research

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Surgical glove perforation

Cited by 139 publications

References 14 publications

CSF Shunt Infection; Peadriatic Cerebrospinal Fluid Shunt Infection. Analysis of Risk Factors Instigating

CSF Shunt Infection; Peadriatic Cerebrospinal Fluid Shunt Infection. Analysis of Risk Factors Instigating

Glove perforations during open surgery for gynaecological malignancies

CORR Insights®: High Risk of Surgical Glove Perforation From Surgical Rotatory Instruments

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