Understanding the Issues of Double Gloving

FACTORS IMPACTING GLOVE FAILURE

There are many factors in the operating room that act as mechanical stressors on the glove, and will influence the glove’s performance. A literature review finds several studies done to look at glove perforation rate during operations. Glove perforation rates vary from 22% to 61% during various types of surgical procedures, with the highest reported in orthopedics, trauma and thoracic surgery, because in those fields the surgeon faces sharp fractured bones or bony structures in the thoracic cage.⁷

Laine’s study showed that the rate of glove perforation was 18.3% for operations.⁸ Yinusa found a glove perforation rate in nearly half of orthopedic cases, and that the operative team members (surgeons and nurses) were at significant risk of exposure to patients’ body fluid.⁹ There was a lower frequency of glove perforations in laparoscopic procedures, although the rate indicated by the study was still a remarkable 20%.⁸ Suture needles are the most frequent source of injury and are involved in as many as 77% of injuries.⁷ 16% of injuries occur while passing sharp instruments hand-to-hand. Most injuries are self-inflicted, but a notable number, perhaps as many as 24% are inflicted by a coworker.¹⁰ One third of devices that cause injuries come in contact with the patient after the injury to the healthcare worker, so there is also risk of disease transmission from healthcare worker to patient.¹⁰

Boney procedures have been associated with higher glove failure than soft-tissue surgery.^10,11 There is a trend in the literature showing that in any type of surgery, a higher percentage of instrumentation is associated with a higher glove failure rate. Injuries are most likely to occur on the non-dominant hand and involve primarily the index finger, followed by the thumb, then the second finger and finally the palm dorsa.⁷

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