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口腔颌面外科手术中手术手套穿孔及锐器伤的评估

Evaluation of Surgical Glove Perforation and Sharps Injury in Oral and Maxillofacial Surgery.

作者信息

Osodin Timothy E, Akadiri Oladimeji A, Akinmoladun Victor I

机构信息

Department of Oral and Maxillofacial Surgery, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria.

Department of Oral and Maxillofacial Surgery, College of Health Sciences, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria.

出版信息

J West Afr Coll Surg. 2022 Oct-Dec;12(4):1-5. doi: 10.4103/jwas.jwas_98_22. Epub 2022 Nov 23.

Abstract

INTRODUCTION

The risk of exposure to infections during surgery is partly mitigated by gloving. However, perforation can reduce the effectiveness of gloving as a barrier to exposure. This study aimed at investigating the frequency of surgical glove perforation and factors predictive of these in our oral and maxillofacial surgical practice.

MATERIALS AND METHODS

The study was carried out at the National Hospital and the University of Abuja Teaching Hospital, Abuja, Nigeria. Consenting patients requiring oral surgical interventions were consecutively recruited into the study. Similarly, surgeons and their assistants who consented to the study were also enlisted in the study. At the end of every surgical procedure, gloves used by the surgeons and the assistants were tested for perforation. Variables investigated included the rate of perforations, the influence of the type of gloving, single versus double gloving, type of anaesthesia, and duration of surgery on rates.

RESULTS

At a minimum of three operators per procedure, a total of 154 participants were involved in the study and 895 gloves were used. The number of glove perforations was 117(13.1%) with 82 (70.1%) involving the surgeons. There were 58/117 (49.6%) cases of perforation involving the dominant hand. Forefinger glove perforation accounted for 62 (52.9%) cases. Wire-related perforations were 72 (61.5%). Overall, nine cases of percutaneous injury were recorded. Duration of operation and double gloving were the predictive factors for perforations.

CONCLUSION

Risk of sharps injury was relatively high due to the high incidence of glove perforation.

摘要

引言

手术过程中戴手套可部分降低感染风险。然而,手套穿孔会降低其作为防护屏障的有效性。本研究旨在调查口腔颌面外科手术中手术手套穿孔的频率及其预测因素。

材料与方法

本研究在尼日利亚阿布贾的国家医院和阿布贾大学教学医院开展。连续招募同意参与研究的需要口腔外科手术干预的患者。同样,同意参与研究的外科医生及其助手也被纳入研究。在每台手术结束时,对外科医生和助手使用的手套进行穿孔检测。调查的变量包括穿孔率、手套类型(单手套与双手套)、麻醉类型以及手术持续时间对穿孔率的影响。

结果

每台手术至少有三名操作人员,共有154名参与者参与研究,共使用了895只手套。手套穿孔数量为117只(13.1%),其中82只(70.1%)涉及外科医生。有58/117(49.6%)例穿孔发生在优势手。食指手套穿孔占62例(52.9%)。与金属丝相关的穿孔有72例(61.5%)。总体而言,记录到9例经皮损伤。手术持续时间和双手套佩戴是穿孔的预测因素。

结论

由于手套穿孔发生率高,锐器伤风险相对较高。

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本文引用的文献

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Clin Orthop Relat Res. 2016 Nov;474(11):2513-2517. doi: 10.1007/s11999-016-4948-3. Epub 2016 Jun 23.
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Blunt wires in oral and maxillofacial surgery.口腔颌面外科中的钝性器械
Br J Oral Maxillofac Surg. 2015 Mar;53(3):301-2. doi: 10.1016/j.bjoms.2014.12.003. Epub 2014 Dec 29.
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Risk of surgical glove perforation in oral and maxillofacial surgery.口腔颌面外科手术中手术手套穿孔的风险。
Int J Oral Maxillofac Surg. 2012 Aug;41(8):1014-9. doi: 10.1016/j.ijom.2012.02.010. Epub 2012 Mar 23.
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Incidence and patterns of needlestick injuries during intermaxillary fixation.颌间固定期间针刺伤的发生率及模式。
Br J Oral Maxillofac Surg. 2011 Apr;49(3):221-4. doi: 10.1016/j.bjoms.2010.04.010. Epub 2010 May 21.
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Influence of double-gloving on manual dexterity and tactile sensation of surgeons.双层手套对手术医生手灵活性和触觉的影响。
J Am Coll Surg. 2010 Mar;210(3):325-30. doi: 10.1016/j.jamcollsurg.2009.11.001. Epub 2009 Dec 24.
9
Do surgical personnel really need to double-glove?外科手术人员真的需要戴双层手套吗?
AORN J. 2009 Feb;89(2):322-8; quiz 329-32. doi: 10.1016/j.aorn.2008.11.001.

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