Glove perforation in orthopaedics: Probability of tearing gloves during high-risk events in trauma surgery

Nikita Lakomkin, Aristides I. Cruz, Peter D. Fabricant, Andrew G. Georgiadis, John Todd R. Lawrence

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Objective: To assess the risk of glove perforation during common maneuvers or events in trauma-related orthopaedic surgical procedures. Methods: Four investigators executed 6 high-risk maneuvers in a simulated laboratory setting. Alternative techniques were also performed for most maneuvers. Glove integrity was examined by 2 standard methods of fluid leak testing. The rates of perforation were compared between techniques using χ2 and Fisher exact tests. Results: Investigators were only able to identify 14.3% of perforations. Cleaning drill bit flutes by hand had the highest overall tear rate (85%). Catching a glove along the guide wire when passing a cannulated drill bit resulted in a 50% perforation rate. Catching a glove around a rotating drill shaft had a tear rate of 40%. Palpating the end of a flexible nail cut with a wire cutter had a significantly higher perforation rate than a nail cut with a proprietary, nail-specific tool (35% vs. 5%, P = 0.022). Blind digital fracture reduction had a tear rate that was not statistically different than directly visualizing the reduction (20% vs. 15%, P = 0.5). Inserting screws while stabilizing the threads with one's fingers resulted in a perforation rate of 15%. Conclusions: Orthopaedic surgeons should be aware that microperforation of surgical gloves often goes undetected and should consider modifying or using alternative techniques when performing certain surgical maneuvers. The results of this study can be used by orthopaedic and surgical first assist training programs to promote safe surgical practice.

Original languageEnglish (US)
Pages (from-to)474-479
Number of pages6
JournalJournal of orthopaedic trauma
Volume32
Issue number9
DOIs
StatePublished - Jan 1 2018

Keywords

  • Contamination
  • Glove tears
  • Infection
  • Microperforations
  • Orthopaedic trauma
  • Surgical safety

PubMed: MeSH publication types

  • Journal Article
  • Comparative Study

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