Caillot J L, Côte C, Abidi H, Fabry J
Surgical Emergency Service, Centre hospitalier Lyon-Sud, Pierre Bénite, France.
Br J Surg. 1999 Nov;86(11):1387-90. doi: 10.1046/j.1365-2168.1999.01266.x.
Breakdown of the surgeon-patient barrier represents a risk for transmission of infectious disease. Such breakdowns are frequently not recognized by the surgical team. The protection afforded by double gloving under normal operating conditions was evaluated.
An electronic device detected breakdown of the surgeon-patient barrier in a series of 80 surgical procedures, randomly assigned to either double or single gloving. Fluid contact due to glove perforation, porosity or gown wetting was recorded during 151 individual surgeon episodes covering 238 operator-hours. Surgical procedures were called superficial for incisions of less than 10 cm.
Double gloving reduced the number of perforation and porosity alarms twofold in both superficial and deep surgical procedures. Deep procedures carried a sevenfold increased risk of barrier breakdown compared with superficial procedures, the risk being greatest for the principal operator.
Without electronic detection, a large majority of barrier breakdowns would remain undetected by the surgical team and lead to prolonged contact with potentially contaminating body fluids. The use of double gloving provides real protection against such contamination risks.
医患屏障的破损存在传染病传播风险。手术团队常常意识不到此类破损情况。我们评估了在正常手术条件下双层手套提供的防护作用。
一种电子设备在80例外科手术中检测医患屏障的破损情况，这些手术被随机分配采用双层或单层手套。在涵盖238个术者工时的151次术者个人操作期间，记录因手套穿孔、孔隙或手术衣浸湿导致的液体接触情况。手术切口小于10厘米的手术被称为浅表手术。
在浅表和深部外科手术中，双层手套使穿孔和孔隙警报数量减少了一半。与浅表手术相比，深部手术的屏障破损风险增加了7倍，主要术者面临的风险最大。
若无电子检测，手术团队绝大多数情况下都无法察觉屏障破损，这会导致与潜在污染体液的长时间接触。使用双层手套可切实防范此类污染风险。
