Surgical Glove Perforation: An Indiscernible Hazard

since long the surgical glove has been known to protect the patient from infection and hence morbidity. With increase in incidence of HIV, Hep B and Hep c, gloves are also important in protecting the surgeon as well. We conducted a study to investigate the incidence of glove perforation both occult and revealed in various members of the surgical team, both in conventional as well as laparoscopic surgeries separately.

As a study material we gathered gloves from the surgeries performed in a single unit at the Department Of General Surgery, J.L.N Medical College, Ajmer during two years. 10072 gloves from 1577 surgeries were gathered and tested using the standard water filling test.

In 1397 conventional surgeries 8632 gloves were used and 1051 gloves (12.18%) were found to be punctured, out of which only 252 (23.98%) of those who had punctured the gloves were aware that they have perforated the glove. glove perforation was found to be more common with the operating surgeon, 495 out of 1051 (47.10%) gloves perforated, followed by the scrub nurse with 340 (32.35%) gloves perforated, the first assistant had the least 219 glove perforated (20.83%). In 180 Laparoscopic surgeries 1440 gloves were used and 54 (3.75%) were found to be punctured out of which none of the wearers were aware of the perforation. Here also the operating surgeon had the most gloves perforated 30 out of 54 (55.56%) followed by staff nurse with 18 gloves punctured (33.33%) followed by the assistant with only 6 glove perforation (11.11%) the camera assistant had none. we also found that the most number of gloves punctured were of the non-dominant hand 671 of total 1105 gloves (60.72%). Most common site of perforation was found to be the index finger.

only a few surgical glove perforations are noticed by the surgeon at the time of surgery making it an occult risk. The glove of the non-dominant hand was more commonly perforated, maybe because the dominant hand usually holds the sharp instrument and the index finger of the non-dominant hand is used to guide the needle through the tissues. Glove perforation was unexpectedly common among scrub nurses, which might be a result of increased handling of the instruments during the setting up of the instrument trolley. Incidence of glove perforation was less with laparoscopic surgeries.