Association Between the Frequency of Glove Change and the Risk of Blood and Body Fluid Exposure in Gastrointestinal Surg
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ORIGINAL SCIENTIFIC REPORT
Association Between the Frequency of Glove Change and the Risk of Blood and Body Fluid Exposure in Gastrointestinal Surgery Minako Kobayashi1 • Hironori Tsujimoto1 • Risa Takahata1 • Takahiro Einama2 • Koichi Okamoto2 • Yoshiki Kajiwara2 • Eiji Shinto2 • Yoji Kishi2 • Kazuo Hase2 • Hideki Ueno2
Accepted: 1 July 2020 Ó Socie´te´ Internationale de Chirurgie 2020
Abstract Background Surgical gloves are used to prevent the transmission of microorganisms from the surgeon’s hands to the patient and vice versa. Little is known on the optimal frequency of glove changing. Therefore, we aimed to examine the optimal frequency of glove change during surgery by assessing the glove perforation rate in gastrointestinal surgery. Methods In this observational prospective cohort study, we investigated the incidence of perforation of 5,267 gloves during gastrointestinal surgeries. Results The overall glove perforation rate was 10.1%. There was no significant difference between single gloving (10.2%) and double gloving (10.0%; p = 0.8491). However, the perforation rate of the inner glove (5.7%) was found to be significantly lower than that of the outer glove (11.6%) (p \ 0.0001). A significant difference in perforation rate was observed after wearing inner gloves for 240 min (\ 240 min, 4.4%; B 240 min, 7.2%; p = 0.0314), and outer gloves for 60 min (\ 60 min, 7.1%; B 60 min, 12.6%; p \ 0.0001). We found cumulative perforation rate to rapidly increase until the wear time was 90 min. Conclusion The inner gloves and outer gloves have a higher perforation rate as the wear time increased. To reduce the risk of intraoperative blood and fluid exposure and prevent healthcare-associated infection, gloves should be changed for approximately every 60–90 min for outer gloves and approximately every 240 min for inner gloves.
Introduction The use of surgical gloves was first pioneered by William Stewart Halsted at Johns Hopkins Hospital in 1889 [1] with the goal of keeping the hands of the surgical team members from becoming rough. More than 100 years later, the use of gloves is for preventing pathogen transmission between & Minako Kobayashi [email protected] 1
Department of Medical Risk Management and Infection Control, National Defense Medical College, 3-2, Namiki, Tokorozawa, Saitama, Japan
2
Department of Surgery, National Defense Medical College, 3-2, Namiki, Tokorozawa, Saitama, Japan
patients and surgical team members, controlling the exposure risk of surgical team members to blood, and preventing surgical site infections (SSI) [2–4]. To block the transmission of pathogenic microorganisms, gloves must be intact. However, the Acceptable Quality Level (AQL) of new gloves that may possess micro-perforations is 1–4% [5]. Several studies have demonstrated a glove perforation rate as high as 50% depending on needle punctures and glove deterioration [6–9]. It has been reported that glove perforation is directly related to glove wear time, where longer wear times increase the rate of perforation [10]. Surgical tea
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