Glove Perforation Raises Odds of Surgical Site Infection

But surgical antimicrobial prophylaxis eliminates the risk, study finds
By Jane Parry
HealthDay Reporter

THURSDAY, June 18 (HealthDay News) -- Surgical glove perforation significantly increases the risk of surgical site infection in procedures where surgical antimicrobial prophylaxis is not applied, according to a study published in the June issue of the Archives of Surgery.

Heidi Misteli, M.D., of the University Hospital Basel in Switzerland, and colleagues conducted a study of 4,147 surgical procedures in divisions of visceral surgery, vascular surgery and traumatology to measure the extent of compromised asepsis as a result of glove perforation.

Surgical site infections occurred in 188 (4.5 percent) of the procedures, and such an infection was more likely when glove perforation occurred versus procedures where asepsis was maintained, the investigators discovered. However, in procedures where surgical antimicrobial asepsis was applied, glove perforation did not increase the odds of a surgical site infection, the researchers note.

"Efforts to decrease the frequency of glove perforation, such as double gloving and the routine changing of gloves during lengthy surgical procedures, are therefore encouraged," the authors conclude. "The present results support an extended indication of surgical antimicrobial prophylaxis to all clean procedures in the absence of strict precautions taken to prevent glove perforation. The advantages of this surgical site infection prevention strategy, however, must be balanced against the costs and adverse effects of the prophylactic antimicrobials, such as drug reactions or increased bacterial resistance."

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