Demircay Emre, Unay Koray, Bilgili Mustafa G, Alataca Gulum
Department of Orthopedic Surgery, Baskent University School of Medicine, Uskudar, Istanbul, Turkey.
J Orthop Sci. 2010 Nov;15(6):790-4. doi: 10.1007/s00776-010-1547-0. Epub 2010 Nov 30.
The transmission of blood-borne pathogens during surgery is a major concern. Surgical gloves are the primary barrier between the surgeon and the patient. Surgical procedures that need manual handling of bony surfaces or sharp instruments have the highest risk of glove perforations. The frequencies and the sites of surgical glove perforations in arthroplasty procedures were assessed.
We assessed the surgical glove perforations in total hip and knee arthroplasty procedures. Double standard latex gloves were used. A total of 983 outer and 511 inner gloves were tested. The gloves of all the surgical team members were tested for perforations during the first and second hours of surgery.
There were 18.4% outer and 8.4% inner glove perforations. The most frequent site of perforation was the second digit of the nondominant hand (25.5%). We found that hip and knee arthroplasty had significantly more glove perforation risk for the surgeon in the first half of the operation rather than the second half, and 57.8% of the perforations were at the index finger and the thumb.
Arthroplasty procedures still have high glove perforation rates despite the use of double gloving with frequent changes. Extra augmentation of the gloves in selected areas of the hand, in addition to double gloving, may be safer and more cost-effective than double gloving alone.
手术期间血源性病原体的传播是一个主要问题。手术手套是外科医生与患者之间的主要屏障。需要手动处理骨表面或尖锐器械的手术手套穿孔风险最高。评估了关节置换手术中手术手套穿孔的频率和部位。
我们评估了全髋关节和膝关节置换手术中的手术手套穿孔情况。使用双层标准乳胶手套。共测试了983只外层手套和511只内层手套。在手术的第一个小时和第二个小时对所有手术团队成员的手套进行穿孔测试。
外层手套穿孔率为18.4%，内层手套穿孔率为8.4%。最常见的穿孔部位是非优势手的食指（25.5%）。我们发现，髋关节和膝关节置换手术中，外科医生在手术前半段而非后半段的手套穿孔风险显著更高，且57.8%的穿孔发生在食指和拇指处。
尽管使用了双层手套且频繁更换，关节置换手术的手套穿孔率仍然很高。除双层手套外，对手部特定区域的手套进行额外加固可能比单独使用双层手套更安全且更具成本效益。
