Green S E, Gompertz R H
Royal Victoria Infirmary, Newcastle upon Tyne.
Ann R Coll Surg Engl. 1992 Sep;74(5):306-8.
Surgical gloves are important in protecting medical staff from exposure to pathogens during surgery, especially viruses such as hepatitis B and the human immunodeficiency virus. We have studied the incidence and circumstances of surgical glove perforation using a sensitive electronic device. The glove perforation rate during elective general surgery was compared with that seen during an anastomosis workshop, where surgical trainees operated in a laboratory setting. A total of 220 gloves were tested for perforations pre- and postoperatively during general elective surgical procedures. During the surgical training workshop 72 gloves were tested. Fifty-two gloves (24%) were perforated during surgical procedures. Among surgeons, consultants had a significantly lower perforation rate than trainees (26% vs 46%, P < 0.05, chi 2), that for assistants was much lower (9%). The perforation rate for scrub nurses was surprisingly high at 22%. Glove perforation among trainees was significantly lower during workshop procedures than at elective surgery (17% vs 46%, P < 0.05, chi 2), probably because glove perforation occurs commonly at wound closure. Glove perforation remains very common, particularly among surgical trainees. Glove perforation should be reduced by teaching better techniques, especially 'no-touch', particularly for wound closure.
手术手套对于保护医务人员在手术过程中免受病原体感染非常重要，尤其是诸如乙型肝炎病毒和人类免疫缺陷病毒等病毒。我们使用一种灵敏的电子设备研究了手术手套穿孔的发生率及情况。将择期普通外科手术中的手套穿孔率与吻合技术工作坊中的穿孔率进行了比较，在工作坊中外科实习生在实验室环境下进行操作。在普通择期外科手术过程中，总共对220只手套在术前和术后进行了穿孔测试。在外科培训工作坊中，测试了72只手套。52只手套（24%）在手术过程中出现了穿孔。在外科医生中，会诊医生的穿孔率显著低于实习生（26%对46%，P<0.05，卡方检验），助手的穿孔率则低得多（9%）。洗手护士的穿孔率高达22%，令人惊讶。实习生在工作坊操作过程中的手套穿孔率显著低于择期手术时（17%对46%，P<0.05，卡方检验），这可能是因为手套穿孔通常发生在伤口缝合时。手套穿孔仍然非常普遍，尤其是在外科实习生中。应通过教授更好的技术，特别是“无接触”技术，尤其是在伤口缝合时，来降低手套穿孔率。
