Thanni Lateef O A, Yinusa W
Department of Orthopedics and Traumatology, College of Health Sciences, Olabisi Onabanjo University, Ogun State, Nigeria.
J Natl Med Assoc. 2003 Dec;95(12):1184-8.
To determine the usefulness of double gloves in protecting against the exposure of surgical team members' hands to blood.
Five-hundred-ninety-six gloves were studied during 71 orthopedic operations using the water-loading test (filling a glove with water and occluding its cuff tightly to identify leaking points).
In all, 73 glove perforations occurred, but only nine resulted in exposure to blood (blood touching the skin). The incidence of glove perforation was 12% (73/596), and overall exposure (blood touching the skin) per operation was 13% (9/71). The latter would have been 87% (62/71) but for the use of double gloves. Sixteen percent of the perforations in double gloves were in the inner gloves, while 84% were in the outer gloves. Exposure of surgeons was reduced from 54% to 10%, first assistants from 27% to 3%, and second assistants from 7% to 0 (p < 0.02, df = 2) by double-gloving. Significantly more perforations occurred during operations on bone, compared with soft tissue operations, p < 0.0001, RR = 4 (95% CL 1.87-8.55). The most common sites of glove perforation were the index finger (47%), thumb, and the palm region: 14% each. More glove perforations occurred in nondominant hands.
Double-gloving offers additional protection to surgeons and assistants by preventing hand exposure to blood intraoperatively.
确定双层手套在防止手术团队成员手部接触血液方面的作用。
在71例骨科手术中，使用注水试验（向手套内注水并紧紧封住袖口以确定漏血点）对596只手套进行了研究。
总共发生了73次手套穿孔，但只有9次导致血液接触（血液接触皮肤）。手套穿孔的发生率为12%（73/596），每次手术中血液接触皮肤的总体发生率为13%（9/71）。若不使用双层手套，后者发生率将为87%（62/71）。双层手套中，16%的穿孔发生在内层手套，84%发生在外层手套。通过佩戴双层手套，主刀医生的接触率从54%降至10%，第一助手从27%降至3%，第二助手从7%降至0（p<0.02，自由度=2）。与软组织手术相比，骨科手术中手套穿孔明显更多，p<0.0001，相对危险度=4（95%可信区间1.87 - 8.55）。手套穿孔最常见的部位是食指（47%）、拇指和手掌区域，各占14%。非优势手发生的手套穿孔更多。
双层手套通过防止术中手部接触血液，为外科医生和助手提供了额外的保护。
