de Castro-Peraza M E, Garzón-Rodríguez E, Rodríguez-Pérez V, Sosa-Alvarez I, Gutierrez-Hernández J, Asiain-Ugarte C
Bloque Quirúrgico Central, Hospital Universitario de Canarias, Ofra, La Laguna, Santa Cruz de Tenerife, Islas Canarias.
Enferm Clin. 2010 Mar-Apr;20(2):73-9. doi: 10.1016/j.enfcli.2009.10.002. Epub 2010 Jan 29.
To investigate the incidence of glove perforation in programmed surgery and compare perforation rates between single-gloves and double-gloves. To evaluate the extent to which glove perforations remain undetected during surgery.
Randomized and controlled trial. A one year of study period in 2008 consisting of programmed surgeries at the Canary Islands University Hospital. Gloves, randomized into single or double, worn by surgeons, assistants and scrub nurses were analyzed using the Water Leak Test (EN455-1) for 3 min after surgery ended to detect leakage.
A total of 1537 gloves were examined during 113 operations, 7 perforations were noticed during the operation and 104 unnoticed, especially in mayor surgery. Of these, 43 perforations (41.3%) occurred while wearing single gloves and 51 (49%) in the outer of a double glove. Only 10 perforations (9.6%) were found in the inner glove. The perforation rate for surgeons was 9.85%, were slightly greater than nurses at 6,91%, but significantly greater that the rate for assistants, 4,04% (p<0.001).
We conclude that double gloving is effective in surgery, inasmuch as the barrier protection was maintained by the inner glove in four out of five cases when the outer glove was inadvertently perforated. Surgical teams must balance the improved safety of double gloving with the possible discomfort and reduced sensitivity.
调查程序化手术中手套穿孔的发生率,并比较单手套和双手套的穿孔率。评估手术过程中手套穿孔未被发现的程度。
随机对照试验。2008年在加那利群岛大学医院进行了为期一年的程序化手术研究。手术结束后,使用漏水试验(EN455-1)对由外科医生、助手和刷手护士佩戴的随机分为单手套或双手套的手套进行3分钟分析,以检测渗漏情况。
在113例手术中总共检查了1537只手套,手术过程中发现7处穿孔,104处未被发现,尤其是在大手术中。其中,43处穿孔(41.3%)发生在佩戴单手套时,51处(49%)发生在双手套的外层。仅在10只内层手套中发现穿孔(9.6%)。外科医生的穿孔率为9.85%,略高于护士的6.91%,但显著高于助手的4.04%(p<0.001)。
我们得出结论,双手套在手术中是有效的,因为在外层手套意外穿孔的五分之四的情况下,内层手套保持了屏障保护作用。手术团队必须在双手套提高的安全性与可能的不适和灵敏度降低之间取得平衡。