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具有严重后果的损伤:骨科手术中外科乳胶手术手套穿孔情况分析

Damages with High Consequences: Analysis of Perforations in Surgical Latex Operation Gloves from Orthopedic Surgeries.

作者信息

Enz Andreas, Klinder Annett, Mittelmeier Hannah, Kundt Günther, Mittelmeier Wolfram, Zaatreh Sarah

机构信息

Department of Orthopedics, University Medicine Rostock, Rostock, Germany.

Institutes for Biostatistics and Informatics in Medicine and Ageing Research, University of Rostock, Rostock, Germany.

出版信息

Eur J Microbiol Immunol (Bp). 2018 Nov 26;8(4):159-162. doi: 10.1556/1886.2018.00028. eCollection 2018 Dec 23.

Abstract

INTRODUCTION

To prevent surgical site infections (SSIs) during operation, the use of sterile surgical latex gloves is common. The aim of this study was to examine the damage of the gloves in surgeries with different mechanical stress and the influence on the kind of damages. Gloves were collected during primary arthroplasty, revision arthroplasty (hip and knee), and arthroscopy (shoulder, hip, and knee).

MATERIALS AND METHODS

Surgical latex operation gloves were collected from surgeons after the operation and were tested with watertightness test (ISO EN 455-1:2000).

RESULTS

A total of 1460 surgical gloves were retrieved from 305 elective operations. On average, 15.9% of the gloves showed postoperative lesions, with the highest incidence occurring in revision arthroplasty with 25%. In primary and revision arthroplasty, the index finger of the dominant hand was most frequently affected (62.7% and 58.6%); in contrast, gloves from arthroscopies had most lesions on thumb and middle finger (42.9% each). Tear and perforation size differed from ≤1 mm to >5 mm, and primary and revision arthroplasty showed bigger damages.

CONCLUSIONS

Surgical gloves have a high malfunction, which increases with growing mechanical stress. A high rate of perforation occurred mostly in revision arthroplasty. Breaching the integrity of the gloves, especially by high mechanical loads, could lead to an increased rate of infection.

摘要

引言

为防止手术过程中手术部位感染(SSIs),使用无菌手术乳胶手套很常见。本研究的目的是检查在不同机械应力的手术中手套的损坏情况以及对损坏类型的影响。在初次关节置换术、翻修关节置换术(髋和膝)以及关节镜检查(肩、髋和膝)过程中收集手套。

材料与方法

手术结束后从外科医生处收集手术乳胶操作手套,并进行防水性测试(ISO EN 455-1:2000)。

结果

从305例择期手术中总共回收了1460只手术手套。平均而言,15.9%的手套术后出现损伤,其中翻修关节置换术的发生率最高,为25%。在初次和翻修关节置换术中,优势手的食指最常受到影响(分别为62.7%和58.6%);相比之下,关节镜检查用的手套拇指和中指的损伤最多(各为42.9%)。撕裂和穿孔大小从≤1毫米到>5毫米不等,初次和翻修关节置换术显示出更大的损伤。

结论

手术手套故障率高,且随着机械应力增加而上升。高穿孔率大多发生在翻修关节置换术中。手套完整性的破坏,尤其是高机械负荷导致的破坏,可能会导致感染率增加。

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