Glove damage in total hip arthroplasty

Abstract

Background. Glove damage during orthopedic operation can reach an incidence of 26.1%, whereas perforations in gloves go unnoticed by surgical team members in most cases (up to 82%), which certainly increases the risk of wound contamination and hemocontact infection transmission. Aim. The aim of this study was to assess the frequency of glove damage among hip arthroplasty surgical team members, to identify the nature, location, and risk factors of damage to surgical gloves. Materials and methods. A total of 1418 surgical gloves (709 pairs) that were used by surgeons, assistants, and surgical nurses during 154 primary and revision total hip arthroplasty (THA) were included in the analysis in this study. Results. Damage to surgical gloves was observed in 69 (44.8%) operations: 54 operations of the primary THA (42.2%) and 15 revision THA (57.7%). Of 1418 gloves used, 95 were damaged (6.7%); 68 of 1166 gloves (5.8%) were damaged during primary hip arthroplasty and 27 of 252 gloves (10.7%) were damaged during revision THA. During primary and revision arthroplasties, glove perforations were observed in most cases: 83.6% and 85.7%, respectively. Most of the cases of glove damage were found in surgeons (45.2% of cases), and 41.1% and 13.7% of the cases of glove damage were experience by assistants and operating room nurses, respectively. The most frequent location of damage in the gloves was on the second finger of both hands: on the left, 40.3%, and on the right, 33.3%. Gloves were damaged in 42.1% of cases in primary arthroplasties lasting up to 70 min and in 42.3% of cases in those lasting more than 70 min. In revision hip arthroplasties lasting up to 95 min, gloves were damaged in 38.5%, and in revisions that lasted more than 95 min, in 76.9% cases. Discussion. Glove damage during revision THA most often occurs to the surgeon suturing the wound (87.4%) and usually remains unnoticed. Risk factors for glove damage are the length of the operations and the use of sharp tools, knitting needles, and wire. Conclusion. Use of apodactyl operational techniques and periodic change of surgical gloves can reduce the risk of damage to gloves and, as a result, reduce wound contamination and the transmission of blood-borne infections.