Laine T, Aarnio P
Department of Surgery, Satakunta Central Hospital, 28500, Pori, Finland.
Am J Surg. 2001 Jun;181(6):564-6. doi: 10.1016/s0002-9610(01)00626-2.
In surgery, intact gloves protect the surgeon from bloodborne pathogens and the surgical wound from microorganisms on the skin of the surgeon. However, glove perforation is very common, and puncture rates as high as 61% are published in the literature. One objective of this study was to compare puncture rates between a unique double-gloving puncture indication system and single-use gloves, and another was to determine the extent to which glove perforations remain undetected during surgery.
The study material comprised all gloves used in surgical operations at our hospital for a period of 2 months. The analysis was made by the glove type in a prospective and randomized manner. Gloves were tested immediately after the surgical procedure using the approved standardized water-leak method for 2 minutes to detect any holes. The gloves used in this study were either a double-gloving puncture indication system or the standard glove used at our hospital.
In 885 operations altogether, 2,462 gloves were tested; 1,020 single gloves, 1,148 double-glove systems, and 294 combination gloves were studied. The overall perforation rate was 192 out of 2,462 gloves (7.80%), and 162 out of 885 operations (18.3%). The detection of perforation during surgery was 28 out of 76 (36.84%) with single gloves, 77 out of 89 with the double-gloving system (86.52%), and 9 out of 27 with combination gloves (33.33%; P <0.001). The inner glove of the double-gloving system was punctured in 6 out of 88 outer glove perforations (6.82%).
In view of the critical importance of safety at work by having a sterile barrier between surgeon and patient, it is very important to use a double-gloving puncture indication system, at least in operations where there is a high risk of glove perforation.
在外科手术中,完好的手套可保护外科医生免受血源性病原体感染,并保护手术伤口免受外科医生皮肤上微生物的污染。然而,手套穿孔非常常见,文献报道的穿刺率高达61%。本研究的一个目的是比较一种独特的双层手套穿刺指示系统与一次性手套的穿刺率,另一个目的是确定手术过程中手套穿孔未被发现的程度。
研究材料包括我院2个月内外科手术中使用的所有手套。分析以前瞻性和随机方式按手套类型进行。手术结束后,立即使用经批准的标准化漏水方法对2分钟,检测手套是否有任何破洞。本研究中使用的手套要么是双层手套穿刺指示系统,要么是我院使用的标准手套。
总共885例手术中,共检测了2462只手套;研究了1020只单手套、1148个双层手套系统和294只组合手套。2462只手套中总体穿孔率为192只(7.80%),885例手术中有162例(18.3%)。单手套在手术中穿孔的检测率为76只中的28只(36.84%),双层手套系统为89只中的77只(86.52%),组合手套为27只中的9只(33.33%;P<0.001)。双层手套系统的外层手套有88只穿孔,其中内层手套有6只穿孔(6.82%)。
鉴于在外科医生和患者之间设置无菌屏障对工作安全至关重要,使用双层手套穿刺指示系统非常重要,至少在手套穿孔风险较高的手术中如此。