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you're at an increased risk for bloodborne pathogen transmission. You also increase the patient's risk of wound infection via transfer of organ- isms from surgical team members. Not surprisingly, researchers found that healthcare providers observed blood on their hands after surgery more frequently when they wore a single pair of gloves than when they wore 2 pairs of gloves. Study after study shows that double gloving protects against perfora- tions. One study of glove perforations when team members double gloved during hip and knee arthroplasty showed a perforation rate of 18.4% to the outer glove and 8.4% to the inner glove. Interestingly, the most frequent site of perforation was the second finger of the nondomi- nant hand. Another found that single-glove perforations occurred at a rate of 10.87%, compared to 3.34% when 2 pairs of gloves were used. When double gloves were used, the inner glove was perforated at a rate of 0.36%. It's hard to argue against numbers like those. 2. you don't have to change your gloves dur- ing a case. Once you don your gloves for a case, you're good to go, right? Not so fast. We tend to feel safe once we put our gloves on, but it's not necessarily always the case. AORN recommends you inspect gloves immediately after donning them, before making con- tact with the sterile field and throughout use for punctures and tears. AORN also recommends scrub members change their gloves every 90 to 150 minutes, regardless of whether you spot a perforation. Studies demonstrate a correlation between the rate of perforation and length of time gloves are worn. A comparison study of single and double gloving analyzed the frequency of glove perforations during surgery. The rate of perforations during surgical procedures that lasted less than 2 hours was 4.21%; the rate of perforations during procedures that were longer than 2 hours was 11.69%. Researchers calculated the increased perforation risk per additional 10 minutes of operating time to be 1.115 times. When single gloves were worn, the detection rate of 6 6 O U T PAT 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 | February 2015