de Barros Maurício Pandini Monteiro, Godoi Thales Thiago Ferreira, Ferretti Filho Mario, Fernandes Helio Jorge Alchavian, Dos Reis Fernando Baldy
Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil.
Rev Bras Ortop (Sao Paulo). 2021 Jun;56(3):379-383. doi: 10.1055/s-0040-1722591. Epub 2021 Jul 1.
The possibility of perforation of gloves during orthopedic surgeries can reach 56.8%, and it mainly related to the manipulation of blunt instruments. Surgeries for the treatment of fractures and trauma present additional risk due to contact with bone spires. Analysis of the prevalence of loss of integrity of surgical gloves in orthopedic trauma procedures, especially fractures, and evaluation of the surgeon's exposure and contact with secretions from the patient. Macroscopic inspection of the gloves of two surgeons specialized in trauma, over a period of 4 months. Both used two gloves for all procedures and, at the end of the surgery, analyzed the presence or absence of blood stains on the internal gloves and/or fingers. The procedures were categorized according to the time and type of surgery. The intercurrence investigated was the perforation of one or two gloves; if the tear was perceived immediately or only at the end of the surgery, and the location of and reason for the tear, if identified. A total of 210 surgeries were included, 87 of which presented perforations, with 17 cases occurring in both gloves and 70 only in the outer glove. Finally, there was a more significant relationship with open focus surgeries and duration > 60 minutes. Our results suggest that greater care and inspection of gloves to look for damage are needed in prolonged surgeries with an open focus.
骨科手术中手套穿孔的可能性可达56.8%，这主要与钝器操作有关。由于接触骨尖，骨折和创伤治疗手术存在额外风险。 分析骨科创伤手术，尤其是骨折手术中手术手套完整性丧失的发生率，并评估外科医生与患者分泌物的接触情况。 对两名创伤专科医生的手套进行了为期4个月的宏观检查。两人在所有手术中都使用两副手套，手术结束时，分析内手套和/或手指上是否有血迹。手术程序根据时间和类型进行分类。调查的并发情况是一副或两副手套穿孔；撕裂是在手术过程中立即被察觉还是仅在手术结束时被发现，以及撕裂的位置和原因（如果确定）。 共纳入210例手术，其中87例出现穿孔，17例两副手套均穿孔，70例仅外层手套穿孔。最后，开放伤口手术和手术时间>60分钟与之有更显著的关系。 我们的结果表明，在有开放伤口的长时间手术中，需要更加小心并检查手套是否有损坏。
