Note to surgeons: Double glove!
A study in this month's Archives of Surgery from Andreas Widmer's group at the University of Basel evaluated the risk of intraoperative glove perforation on the development of surgical site infection. The investigators found that perforation of gloves occurred in 16% of more than 4,000 procedures studied. For those procedures in which antimicrobial prophylaxis was not used, the adjusted odds ratio for development of surgical site infection following glove perforation was 4.2 (CI95 1.7-10.8, p 0.003). For cases in which antimicrobial prophylaxis was used, there was no difference in infection rates between cases where glove perforations occurred vs. those where no perforation occurred. The implication of this study is that double gloving should become a standard practice. In 2007, the American College of Surgeons recommended that double gloving should be performed to protect the surgeon from coming into contact with the patient's blood and body fluids. Now we know that double gloving will also protect the patient.