Rhinehart Major Brandon M, Murphy Major Michael E, Farley Mary F, Albertini John G
MEDOAC, Wuerzburg, Germany.
Dermatol Surg. 2006 Feb;32(2):170-6. doi: 10.1111/j.1524-4725.2006.32031.x.
Mohs micrographic surgery (MMS) is an outpatient procedure that has become the treatment of choice for certain cutaneous malignancies. Although the major steps in this procedure are relatively standardized, one difference involves the use of sterile or nonsterile, clean gloves during the tumor removal phase.
This retrospective chart review study was performed to evaluate whether infection rates are affected by the use of sterile versus nonsterile gloves in the tumor extirpation phase of MMS.
This study evaluated the surgical records of 1,810 consecutive Mohs patients, of which 1,239 Mohs patients (1,400 Mohs procedures) met inclusion criteria. Age, sex, tumor diagnosis, anatomic location, number of Mohs stages, area of the defect, closure type, cartilage exposure, and sterile versus nonsterile glove use were recorded and evaluated.
Twenty-five infections were identified. Statistically significant infection rates were discovered for patients with cartilage fenestration with secondary healing and malignant melanoma diagnosis only. There was no statistical difference in infection rates with all other measured variables to include the use of sterile or clean, nonsterile gloves.
Our study lends support to the contention that clean, nonsterile gloves are safe and effective for use in the tumor extirpation phase of MMS, at a significant cost savings.
莫氏显微外科手术（MMS）是一种门诊手术，已成为某些皮肤恶性肿瘤的首选治疗方法。尽管该手术的主要步骤相对标准化，但一个差异在于在肿瘤切除阶段使用无菌或非无菌的清洁手套。
进行这项回顾性图表审查研究，以评估在MMS的肿瘤切除阶段使用无菌手套与非无菌手套是否会影响感染率。
本研究评估了1810例连续的莫氏患者的手术记录，其中1239例莫氏患者（1400例莫氏手术）符合纳入标准。记录并评估年龄、性别、肿瘤诊断、解剖位置、莫氏分期数量、缺损面积、闭合类型、软骨暴露情况以及使用无菌手套与非无菌手套的情况。
共发现25例感染。仅在软骨开窗且二期愈合以及诊断为恶性黑色素瘤的患者中发现了具有统计学意义的感染率。在所有其他测量变量（包括使用无菌或清洁的非无菌手套）方面，感染率没有统计学差异。
我们的研究支持以下观点，即清洁的非无菌手套在MMS的肿瘤切除阶段使用是安全有效的，且能显著节省成本。
