Glove perforation in hip and knee arthroplasty

Abstract

Background: The transmission of blood-borne pathogens during surgery is a major concern. Surgical gloves are the primary barrier between the surgeon and the patient. Surgical procedures that need manual handling of bony surfaces or sharp instruments have the highest risk of glove perforations. The frequencies and the sites of surgical glove perforations in arthroplasty procedures were assessed.

Methods: We assessed the surgical glove perforations in total hip and knee arthroplasty procedures. Double standard latex gloves were used. A total of 983 outer and 511 inner gloves were tested. The gloves of all the surgical team members were tested for perforations during the first and second hours of surgery.

Results: There were 18.4% outer and 8.4% inner glove perforations. The most frequent site of perforation was the second digit of the nondominant hand (25.5%). We found that hip and knee arthroplasty had significantly more glove perforation risk for the surgeon in the first half of the operation rather than the second half, and 57.8% of the perforations were at the index finger and the thumb.

Conclusions: Arthroplasty procedures still have high glove perforation rates despite the use of double gloving with frequent changes. Extra augmentation of the gloves in selected areas of the hand, in addition to double gloving, may be safer and more cost-effective than double gloving alone.