Idota Nozomi, Nakamura Mami, Akasaka Yoshihisa, Tsuboi Hajime, Bando Risa, Ikegaya Hiroshi
Department of Forensic Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Medicine (Baltimore). 2019 Jul;98(27):e16348. doi: 10.1097/MD.0000000000016348.
Medical staff face the risk of exposure to blood-borne infectious agents during postmortem examinations. This study investigated the effectiveness of non-slip work gloves worn over 2 layers of surgical latex gloves (outer and inner gloves) as a means of reducing hand and finger injuries. Complete sets of outer and inner gloves worn during postmortem examinations were collected from participating forensic staff. Latex gloves were categorized into 2 groups based on the users' actions during the examination: the wearing group if the wearer wore their work gloves continuously without interruption, and the taking-off group if the wearer removed them at least once. Perforation rates, locations, and shapes were compared between these groups. Outer-glove perforation occurred significantly more often in the taking-off group (n = 102 pairs) than in the wearing group (n = 91 pairs) (30.4% vs 3.8%, P < .001). Inner-glove perforation occurred at rates of 2.0% and 0.5% (P = .38), respectively. The wearers did not incur hand or finger injuries. Perforation rates were similar between the dominant and non-dominant hands (P = .18). Regarding location, gloves were punctured most frequently at the thumb, followed by the index finger. Most examiners (85.6%) did not notice the perforation when the damage occurred. Therefore, we could not confirm that a specific operation within a set of plural operations affected the rate of perforation. Additionally, we could not prove a relationship between glove perforation and each operation performed with/without work gloves. The perforation appearances varied greatly in shape and size, suggesting multiple causes of perforation. The continuous (i.e., uninterrupted) wear of work gloves during postmortem examinations reduced the incidence of perforations in both latex glove layers and thus reduced the risk of hand and finger injury.
医务人员在尸体解剖检查过程中面临接触血源性病原体的风险。本研究调查了在两层手术乳胶手套(外层和内层手套)上佩戴防滑工作手套作为减少手部和手指损伤手段的有效性。从参与研究的法医工作人员那里收集了尸体解剖检查期间佩戴的外层和内层手套的完整套装。根据使用者在检查过程中的行为,乳胶手套被分为两组:如果佩戴者持续不间断地佩戴工作手套,则为佩戴组;如果佩戴者至少摘下一次手套,则为摘下组。比较了这两组之间的穿孔率、位置和形状。外层手套穿孔在摘下组(n = 102双)中比在佩戴组(n = 91双)中显著更频繁发生(30.4%对3.8%,P <.001)。内层手套穿孔发生率分别为2.0%和0.5%(P =.38)。佩戴者未发生手部或手指损伤。优势手和非优势手的穿孔率相似(P =.18)。关于位置,手套最常被刺破的部位是拇指,其次是食指。大多数检查人员(85.6%)在损伤发生时未注意到穿孔。因此,我们无法确认一组多项操作中的特定操作是否会影响穿孔率。此外,我们无法证明手套穿孔与佩戴/不佩戴工作手套进行的每项操作之间存在关联。穿孔外观在形状和大小上差异很大,表明穿孔有多种原因。在尸体解剖检查期间持续(即不间断)佩戴工作手套可降低两层乳胶手套的穿孔发生率,从而降低手部和手指受伤的风险。