Apt L, Miller K M
Jules Stein Eye Institute, UCLA School of Medicine.
Trans Am Ophthalmol Soc. 1992;90:71-91; discussion 92-5.
We examined the latex surgical gloves used by 56 primary surgeons in 454 ophthalmic surgical procedures performed over a 7-month period. Of five techniques used to detect pinholes, air inflation with water submersion and compression was found to be the most sensitive, yielding a 6.80% prevalence in control glove pairs and a 21.8% prevalence in postoperative study glove pairs, for a 15.0% incidence of surgically induced perforations (P = 0.000459). The lowest postoperative perforation rate was 11.4% for cataract and intraocular lens surgery, and the highest was 41.7% for oculoplastic procedures. Factors that correlated significantly with the presence of glove perforations as determined by multiple logistic regression analysis were oculoplastic and pediatric ophthalmology and strabismus surgical procedures, surgeon's status as a fellow in training, operating time, and glove size. The thumb and index finger of the nondominant hand contained the largest numbers of pinholes. These data suggest strategies for reducing the risk of cross-infection during ophthalmic surgery.
我们检查了56位主刀医生在7个月内进行的454例眼科手术中使用的乳胶手术手套。在用于检测针孔的五种技术中，水浸充气和压缩法被发现最为灵敏，在对照手套对中的患病率为6.80%，在术后研究手套对中的患病率为21.8%，手术引起的穿孔发生率为15.0%（P = 0.000459）。白内障和人工晶状体手术的术后最低穿孔率为11.4%，眼部整形手术的最高穿孔率为41.7%。经多因素logistic回归分析确定，与手套穿孔存在显著相关的因素包括眼部整形、小儿眼科和斜视手术、作为培训学员的外科医生身份、手术时间和手套尺寸。非优势手的拇指和食指针孔数量最多。这些数据提示了降低眼科手术中交叉感染风险的策略。
