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开放性腹部手术中手套穿孔的发生率及相关危险因素。

Rate of Glove Perforation in Open Abdominal Surgery and the Associated Risk Factors.

机构信息

1 Institute of Health Science, Department of Surgical Nursing, Manisa Celal Bayar University, Manisa, Turkey.

2 Faculty of Health Science, Department of Surgical Nursing, Manisa Celal Bayar University, Manisa, Turkey.

出版信息

Surg Infect (Larchmt). 2019 May/Jun;20(4):286-291. doi: 10.1089/sur.2018.229. Epub 2019 Feb 8.

Abstract

Glove perforation is common during surgery. Surgical gloves are used as personal protective equipment to reduce infection risks from bloodborne pathogens for both the surgical team and patients. This research was conducted to determine the perforation rates of gloves worn in open abdominal surgery performed in a general surgery department and the risk factors affecting perforation. This research was designed as an observational prospective cohort study including 70 open abdominal operations. There were four members of the surgical team (surgeon, first assistant, second assistant, and scrub nurse). A total of 280 (70 × 4) pairs of gloves in 70 consecutive open abdominal procedures were included in this study. A total of 140 unused gloves were tested as control group to assess perforations and pre-existing leaks. After the operation, all gloves were checked for water impermeability using the EN455-1 method and the presence or absence of a puncture hole was recorded. Glove perforation was detected in 54.3% of operations. The rate of perforation in all gloves was 10.7%, of which 78% unnoticed by the surgical team during surgical procedure. It was determined that the puncture in the gloves was mostly on the non-dominant hand (left). For the left-hand glove, the highest number of holes was observed on the index finger (21.1%) and palm/dorsum of the hand (21.1%). The risk of glove perforation was 5.8 times greater for surgeons compared with the other team members, and operation time of 61 minutes or longer increased the risk of perforation by 12.77 times. Glove perforation rates are high in open abdominal surgery. The highest number of perforations occurred in the non-dominant hand (left) has a high rate of perforation in surgeons and long operations. It may be beneficial for surgical team members to change gloves at certain intervals during surgery or use indicator glove systems.

摘要

手套穿孔在手术中很常见。手术手套用作个人防护设备,以降低手术团队和患者血液传播病原体感染的风险。本研究旨在确定普外科开放性腹部手术中使用的手套穿孔率以及影响穿孔的危险因素。本研究设计为观察性前瞻性队列研究,包括 70 例开放性腹部手术。手术团队由 4 名成员组成(外科医生、第一助手、第二助手和洗手护士)。本研究共纳入 70 例连续开放性腹部手术的 280 对(70×4)手套。共 140 只未使用的手套作为对照组进行测试,以评估穿孔和预先存在的泄漏。手术后,所有手套均采用 EN455-1 方法进行不透水性检查,并记录是否存在穿刺孔。54.3%的手术中发现手套穿孔。所有手套的穿孔率为 10.7%,其中 78%在手术过程中未被手术团队发现。结果表明,手套上的穿刺主要发生在非优势手(左手)。对于左手手套,食指(21.1%)和手掌/手背(21.1%)的穿孔数最多。与其他团队成员相比,外科医生的手套穿孔风险高 5.8 倍,手术时间超过 61 分钟穿孔风险增加 12.77 倍。开放性腹部手术中手套穿孔率较高。非优势手(左手)的穿孔数最多,外科医生的穿孔率较高,手术时间较长。在手术过程中,手术团队成员每隔一定时间更换手套或使用指示手套系统可能会有所受益。

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