9 8
O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | M A R C H 2 0 1 4
Surgery's riskiest specialty
A report in Acta Orthopædica Belgica (
tinyurl.com/qammhpz
), official
journal of the Belgian Society of Orthopedics and Traumatology, says
glove perforation rates range from 10% in ophthalmology to 50% in
general surgery. But the stress and strain of manipulating oscillating
saws, metal instruments and implants during orthopedic procedures
subject gloves to extreme shear force, putting orthopods at the great-
est risk among surgical specialties, say the researchers.
In this study, the researchers assessed rates of glove perforations
during major total hip and knee replacements and the more minor
knee arthroscopies. They also examined how double-gloving
impacted perforation rates and whether rates differed among sur-
geons, their assistants and OR nurses.
The overall glove perforation rate was 15.8%, with a 3.6% rate during
arthroscopies and a 21.6% rate during joint replacements. More than
72% of the breaches went unnoticed until after the procedures had
concluded. Only 3% of the inner gloves were jeopardized — none dur-
ing arthroscopies — compared with 22.7% of the outer gloves.
Notably, only 4% of perforations recorded during major procedures
involved both glove layers. A quarter of the 668 surgeons involved in
the study suffered perforated gloves, which was significantly higher
than the 8% of the 348 assistants and 512 nurses who suffered the
same fate.
The researchers note that double-gloving in orthopedic procedures
significantly reduces the incidence of perforation of inner gloves.
Although surgical personnel who scrub in properly lower their risks
of contracting bloodborne diseases when gloves are perforated, they
add, previous studies have shown bacteria cultures taken at perfora-
tion sites have been positive about 10% of the time.
D O U B L E - G L O V I N G
OSE_1403_part2_Layout 1 3/5/14 10:53 AM Page 98
