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[手术手套穿孔的风险]

[The risk of surgical glove perforations].

作者信息

Hagen Gerd Ødegård, Arntzen Halvard

机构信息

Molde sjukehus, 6407 Molde.

出版信息

Tidsskr Nor Laegeforen. 2007 Mar 29;127(7):856-8.

Abstract

BACKGROUND

The increasing prevalence of blood-borne viral diseases has drawn attention to the barrier between the surgical personnel's hands and the patients body fluids during surgery. At present, the typical practice is to use double gloving in orthopaedic surgery, and single gloving in other types of surgery. The main purpose of our study was to estimate and compare the perforation risk in different categories of surgery.

MATERIAL AND METHODS

In a series of 655 surgical operations covering 5 main categories of surgery, all detected glove perforations were recorded and analysed.

RESULTS

Perforations were found in 203 out of 655 operations (31%). The observed perforation frequency was 44.5% in gastrointestinal surgery, 34.7% in orthopaedic surgery, 31.1% in gynaecology, 18.6% in vascular surgery and 9.2% in general surgery. In some subcategories, the frequencies were even higher.

INTERPRETATION

In several categories of surgery, we found high perforation frequencies. Perforations in single gloves are often not detected during operations. This may increase the risk of transmission of blood-borne infections, particularly because the time of exposure may be long. Double indicator gloves make the intra-operative detection of perforations easier. Also double gloving is known to significantly reduce the perforation risk. The use of double indicator gloves is recommended in all categories of surgery.

摘要

背景

血源性病毒疾病的患病率不断上升,这使得人们关注手术过程中医护人员手部与患者体液之间的屏障。目前,典型的做法是在骨科手术中使用双层手套,而在其他类型的手术中使用单层手套。我们研究的主要目的是评估和比较不同类别手术中的穿孔风险。

材料与方法

在涵盖5种主要手术类别的655例外科手术中,记录并分析所有检测到的手套穿孔情况。

结果

655例手术中有203例(31%)发现穿孔。观察到的穿孔频率在胃肠外科手术中为44.5%,骨科手术中为34.7%,妇科手术中为31.1%,血管外科手术中为18.6%,普通外科手术中为9.2%。在一些子类别中,频率甚至更高。

解读

在几类手术中,我们发现穿孔频率很高。手术过程中单层手套的穿孔往往不易被察觉。这可能会增加血源性感染传播的风险,特别是因为暴露时间可能很长。双层指示手套使术中更容易检测到穿孔。而且已知双层手套能显著降低穿孔风险。建议在所有手术类别中使用双层指示手套。

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