Institute of Hygiene and Environmental Medicine, Ernst-Moritz-Arndt University, Greifswald, Germany.
BMC Infect Dis. 2013 May 20;13:226. doi: 10.1186/1471-2334-13-226.
The use of examination gloves is part of the standard precautions to prevent medical staff from transmission of infectious agents between patients. Gloves also protect the staff from infectious agents originating from patients. Adequate protection, however, depends on intact gloves. The risk of perforation of examination gloves is thought to correlate with duration of wearing, yet, only very few prospective studies have been performed on this issue.
A total number of 1500 consecutively used pairs of examination gloves of two different brands and materials (latex and nitrile) were collected over a period of two months on two ICU's. Used gloves were examined for micro perforations using the "water-proof-test" according to EN 455-1. Cox-regression for both glove types was used to estimate optimal changing intervals.
Only 26% of gloves were worn longer than 15 min. The total perforation rate was 10.3% with significant differences and deterioration of integrity of gloves between brands (p<0.001). Apart from the brand, "change of wound dressing" (p = 0.049) and "washing patients" (p = 0.001) were also significantly associated with an increased risk of perforation.
Medical gloves show marked differences in their durability that cannot be predicted based on the technical data routinely provided by the manufacturer. Based on the increase of micro perforations over time and the wearing behavior, recommendations for maximum wearing time of gloves should be given. Changing of gloves after 15 min could be a good compromise between feasibility and safety. HCWs should be aware of the benefits and limitations of medical gloves. To improve personal hygiene hand disinfection should be further encouraged.
使用检查手套是标准预防措施的一部分,可防止医护人员在患者之间传播感染源。手套还可保护医护人员免受来自患者的感染源的侵害。然而,充分的保护取决于手套完好无损。手套穿孔的风险被认为与佩戴时间有关,但仅有极少数前瞻性研究对此问题进行了研究。
在两个月的时间里,我们在两个 ICU 连续收集了 1500 对来自两个不同品牌和材料(乳胶和丁腈)的已使用的检查手套。使用“防水测试”(根据 EN 455-1)对使用过的手套进行微小穿孔检查。使用 Cox 回归对两种手套类型进行了分析,以估计最佳更换间隔。
只有 26%的手套佩戴时间超过 15 分钟。总穿孔率为 10.3%,且品牌之间的手套完整性有明显差异和恶化(p<0.001)。除了品牌之外,“更换伤口敷料”(p = 0.049)和“清洗患者”(p = 0.001)也与穿孔风险增加显著相关。
医用手套在耐用性方面存在明显差异,无法根据制造商常规提供的技术数据进行预测。根据随时间推移而增加的微穿孔和佩戴行为,建议为手套规定最长佩戴时间。每 15 分钟更换一次手套可能是可行性和安全性之间的良好折衷。HCWs 应该了解医用手套的优点和局限性。为了改善个人卫生,应进一步鼓励手部消毒。