Despite pages upon pages of clinical studies that have proven the effectiveness of double-gloving in protecting surgical team members from sharps injuries, needlesticks and infectious diseases such as HIV, and hepatitis B and C, the practice isn't yet routine. Time and again we hear that clinical proof is needed to drive change in the operating room. Well, here it is.
Indicators of safety
A survey published in the journal Infection Control and Hospital Epidemiology (tinyurl.com/pdjoesh) reveals 99% of polled surgeons suffered at least 1 needlestick in their careers. The problem, note the researchers, is that surgical glove punctures often go unnoticed during cases, meaning surgeons might be exposed to blood and associated infection risks without knowing it.
The researchers say glove puncture rates vary, although risks increase to as high as 70% during longer procedures as well as during surgeries requiring maximum effort in deep cavities and around bones. They further note that research shows the risk of blood contact is decreased from 70% with single gloves to as low as 2% with double gloves, likely because the inner glove was shown to remain intact in up to 82% of cases.
To determine how much blood is transferred through single and double layers of gloves at the point of percutaneous injuries, the researchers stuck pork skin with automatic lancets, which simulated suture needlesticks. According to the findings, a mean volume of 0.064μL of blood is transferred in punctures at a depth of 2.4mm through 1 glove layer, compared with only 0.011μL of blood through double-glove layers, which means the volume was reduced by a factor of 5.8.
Notably, the double gloves used in the study included an indicator system: a green inner glove worn with a straw-colored outer glove. According to the researchers, all punctures of the gloves' outer layers were clearly identifiable by the green coloring of the underglove showing at the puncture site. The color contrast reduces risk of blood exposure by alerting surgeons and staff to breaches that may have otherwise gone unnoticed.