Intraoperative damage to surgical gloves during various operations on the musculoskeletal system: a multicenter study
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ORTHOPAEDIC SURGERY
Intraoperative damage to surgical gloves during various operations on the musculoskeletal system: a multicenter study Andreas Enz1 · Tanja Kostuj2 · Philipp Warnke3 · Katrin Osmanski‑Zenk1 · Wolfram Mittelmeier1 · Annett Klinder1 Received: 7 July 2020 / Accepted: 16 August 2020 © The Author(s) 2020
Abstract Introduction Various orthopedic surgical procedures cause mechanical stress for gloves. In some cases, sharp-edged objects impact on the glove surfaces. The systematic description of lesions is still missing. Methods 2289 gloves from 409 surgeries [primary hip and knee arthroplasties (PA), revisions arthroplasties (RA) and arthroscopic shoulder, hip and knee surgery (AY)] from 3 clinics were examined for lesions using water tightening test according to the European norm EN 455-1. Results Arthroscopies showed the lowest rate of operations with damaged gloves (6.9%). Depending on clinic, 32.7% and 59.2% of PA surgeries generated damaged gloves, while in RA, these numbers rose to 76.0% and 72.8%, respectively. In PA and RA, the most affected finger was the index finger, whereas in arthroscopies, more damage occurred on the middle finger and the thumb. The size of the lesions was rather small with the vast majority being 1 mm or 2 mm in size. Conclusion All investigated interventions led to glove lesions. With increasing mechanical stress, the number of glove defects increased. EN 455 does not account for the intraoperative tear risk. Stricter requirements for gloves should be introduced. Glove change intervals should be defined and implemented, and new materials should be developed. Keywords EN 455-1 · Damage · Orthopedic surgery · Surgical side infection · Glove · Lesions
Introduction Surgical gloves with their thin layer of latex are the only mechanical barrier between the patient and the operating team and are intended, apart from various (constructional-) technical requirements in an operating theatre, to protect both sides against infection [1, 2]. The sterile latex surgical glove is used in a variety of disciplines, for example in gastroscopy, cardiac catheter interventions or in invasive and minimally invasive orthopedic and traumatological procedures [3, 4]. According to the European Committee for Standardization (CEN) standard EN 455, the gloves produced are randomly tested for waterproofness (EN 455-1) * Andreas Enz [email protected]‑rostock.de 1
Orthopädische Klinik und Poliklinik, Universitätsmedizin Rostock, Rostock, Germany
2
Orthopädisch‑Traumatologisches Zentrum, St. Marien-Hospital Hamm, Hamm, Germany
3
Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universitätsmedizin Rostock, Rostock, Germany
by means of a water tightening test (1L water for 2–3 min) and tear resistance (EN 455-2) with a maximum weight of 9 N as standard. The defined acceptable quality limit (AQL) for surgical gloves was 1.5, which means that for 50 tested latex gloves, 2 gloves may be damaged without the production batch having to be discarded [5]. In the draft stan
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