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泌尿外科手术手套的微小穿孔:微创手术与开放手术对比

Microperforations of surgical gloves in urology: minimally invasive versus open surgeries.

作者信息

Feng Tom, Yohannan Jithin, Gupta Angela, Hyndman Matthew E, Allaf Mohammad

机构信息

James Buchanan Brady Urological Institute, Department of Urology, Johns Hopkins Medical Institutions, Baltimore, MD 21230, USA.

出版信息

Can J Urol. 2011 Apr;18(2):5615-8.

Abstract

INTRODUCTION

Surgical glove integrity is important in preventing wound infections and reducing patient mortality. Rates of perforations have been studied in many surgical subspecialties, but glove perforations specific to urology have not been investigated previously. This study aims to determine the incidence of glove perforations during urological surgeries and to investigate differences between open, laparoscopic, and endoscopic procedures.

MATERIALS AND METHODS

A total of 180 gloves were collected from various urological procedures performed at our institution: 59 from endoscopic, 72 from laparoscopic, and 49 from open cases. The gloves were tested for defects by both the water load test and electrical conductance testing. The frequency of defects for each type of procedure along with the length of wear, surgeon experience, and glove brand was analyzed.

RESULTS

Glove defects were detected in 29% of all cases. Microperforations encompassed the majority of the glove defects (23.3%) and were detected in 15.2%, 25.0 %, and 30.6% of the endoscopy, laparoscopic and open surgical cases, respectively. The frequency of perforations noted in the minimally invasive procedures was significantly different across the groups (p < 0.01). There was no statistical significant correlation between glove defects and operation time, surgeon experience, and glove brand.

CONCLUSIONS

The rates of glove perforation (29%) in urological procedures were higher than expected. Given the high rates of glove perforations found, double gloving in urological surgeries may offer a solution to the increased risk for cross contamination from microscopic perforations.

摘要

引言

手术手套的完整性对于预防伤口感染和降低患者死亡率至关重要。许多外科亚专业都对穿孔率进行了研究,但泌尿外科特有的手套穿孔情况此前尚未得到调查。本研究旨在确定泌尿外科手术中手套穿孔的发生率,并调查开放手术、腹腔镜手术和内镜手术之间的差异。

材料与方法

从我们机构进行的各种泌尿外科手术中总共收集了180只手套:59只来自内镜手术,72只来自腹腔镜手术,49只来自开放手术病例。通过水负荷试验和电导测试对手套进行缺陷检测。分析了每种手术类型的缺陷频率以及佩戴时间、外科医生经验和手套品牌。

结果

在所有病例中,29%检测到手套缺陷。微小穿孔占手套缺陷的大多数(23.3%),在内镜手术、腹腔镜手术和开放手术病例中分别有15.2%、25.0%和30.6%检测到微小穿孔。各组中微创手术中观察到的穿孔频率有显著差异(p<0.01)。手套缺陷与手术时间、外科医生经验和手套品牌之间无统计学显著相关性。

结论

泌尿外科手术中手套穿孔率(29%)高于预期。鉴于发现的手套穿孔率较高,泌尿外科手术中双层手套佩戴可能为微观穿孔导致的交叉污染风险增加提供一种解决方案。

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