Skip to main content
Top
Published in: BMC Surgery 1/2017

Open Access 01-12-2017 | Research article

Incidence and patterns of surgical glove perforations: experience from Addis Ababa, Ethiopia

Authors: Abebe Bekele, Nardos Makonnen, Lidya Tesfaye, Mulat Taye

Published in: BMC Surgery | Issue 1/2017

Login to get access

Abstract

Background

Surgical glove perforation is a common event. The operating staff is not aware of the perforation until the procedure is complete, sometimes in as high as 70% of the incidences. Data from Ethiopia indicates that the surgical workforce suffers from a very surgery related accidents, however there is paucity of data regarding surgical glove perforation.
The main objective is to describe the incidence and patterns of surgical glove perforation during surgical procedures and to compare the rates between emergency and elective surgeries at one of the main hospitals in Addis Ababa Ethiopia.

Methods

This is a prospective study, performed at the Minilik II referral hospital, Addis Ababa. All surgical gloves worn during all major surgical procedures (Emergency and Elective) from June 1-July 20, 2016 were collected and used for the study. Standardised visual and hydro insufflation techniques were used to test the gloves for perforations. Parameters recorded included type of procedure performed, number of perforations, localisation of perforation and the roles of the surgical team.

Results

A total of 2634 gloves were tested, 1588 from elective and 1026 from emergency procedures. The total rate of perforation in emergency procedures was 41.4%, while perforation in elective surgeries was 30.0%. A statistically significant difference (P < 0.05) was found in between emergency and elective surgeries.
There were a very high rate of perforations of gloves among first surgeons 40.6% and scrub nurses 38.8% during elective procedures and among first surgeons (60.14%), and second assistants (53.0%) during emergency surgeries.
Only 0.4% of inner gloves were perforated. The left hand, the left index finger and thumb were the most commonly perforated parts of the glove. Glove perforation rate was low among consultant surgeons than residents.

Conclusions

Our reported perforation rate is higher than most publications, and this shows that the surgical workforce in Ethiopia is under a clear and present threat. Measures such as double gloving seems to have effectively prevented cutaneous blood exposure and thus should become a routine for all surgical procedures. Manufacturing related defects and faults in glove quality may also be contributing factors.
Literature
2.
go back to reference Jamal A, Wilkinson S. The mechanical and microbiological integrity of surgical gloves. ANZ J Surg. 2003;73:140–3.CrossRefPubMed Jamal A, Wilkinson S. The mechanical and microbiological integrity of surgical gloves. ANZ J Surg. 2003;73:140–3.CrossRefPubMed
3.
4.
go back to reference Bukhari SS, Harrison RA, Sanderson PJ. Contamination of surgeons glove fingertips during surgical operations. J Hosp Infect. 1993;24:117–21.CrossRefPubMed Bukhari SS, Harrison RA, Sanderson PJ. Contamination of surgeons glove fingertips during surgical operations. J Hosp Infect. 1993;24:117–21.CrossRefPubMed
5.
go back to reference Pitten FA, Herdemann G, Kramer A. The integrity of latex gloves in clinical dental practice. Infection. 2000;28(6):388–92.CrossRefPubMed Pitten FA, Herdemann G, Kramer A. The integrity of latex gloves in clinical dental practice. Infection. 2000;28(6):388–92.CrossRefPubMed
6.
go back to reference Manjunath AP, Shepherd JH, Barton DP, Bridges JE, Ind TE. Glove perforations during open surgery for gynaecological malignancies. BJOG. 2008;115(8):1015–9.CrossRefPubMed Manjunath AP, Shepherd JH, Barton DP, Bridges JE, Ind TE. Glove perforations during open surgery for gynaecological malignancies. BJOG. 2008;115(8):1015–9.CrossRefPubMed
7.
go back to reference Malhotra M, Sharma JB, Wadhwa L, Arora R. Prospective study of glove perforation in obstetrical and gynecological operations: are we safe enough? J Obstet Gynaecol Res. 2004;30(4):319–22.CrossRefPubMed Malhotra M, Sharma JB, Wadhwa L, Arora R. Prospective study of glove perforation in obstetrical and gynecological operations: are we safe enough? J Obstet Gynaecol Res. 2004;30(4):319–22.CrossRefPubMed
8.
go back to reference Solda S, et al. Undetected perforations of surgical gloves during emergency procedures. Rev Assoc Med Bras. 2009;55(5):597–600.CrossRefPubMed Solda S, et al. Undetected perforations of surgical gloves during emergency procedures. Rev Assoc Med Bras. 2009;55(5):597–600.CrossRefPubMed
9.
10.
go back to reference Thomas S, Agarwal M, Mehta G. Intra-operative glove perforation—single versus double gloving in protection against skin contamination. Postgrad Med J. 2001;77:458–60.CrossRefPubMedPubMedCentral Thomas S, Agarwal M, Mehta G. Intra-operative glove perforation—single versus double gloving in protection against skin contamination. Postgrad Med J. 2001;77:458–60.CrossRefPubMedPubMedCentral
11.
go back to reference Bekele A, Kotisso B, Shiferaw S. Work-related operating theatre accidents among surgical residents in Addis Ababa, Ethiopia. East Central Afr J Surg. 2008;13:1. Bekele A, Kotisso B, Shiferaw S. Work-related operating theatre accidents among surgical residents in Addis Ababa, Ethiopia. East Central Afr J Surg. 2008;13:1.
12.
go back to reference Bekele A, Shiferaw S, Gulilat D. Levels and trends of occupational hazards among surgical residents at Tikur Anbessa Hospital, Addis Ababa Ethiopia. East Central Afr J Surg. 2013;18:3. Bekele A, Shiferaw S, Gulilat D. Levels and trends of occupational hazards among surgical residents at Tikur Anbessa Hospital, Addis Ababa Ethiopia. East Central Afr J Surg. 2013;18:3.
13.
14.
go back to reference Pieper SP, Schimmele SR, Johnson JA, Harper JL. A prospective study of the effcacy of various gloving techniques in the application of Erich arch bars. J Oral Maxillofac Surg. 1995;53:1174–6.CrossRefPubMed Pieper SP, Schimmele SR, Johnson JA, Harper JL. A prospective study of the effcacy of various gloving techniques in the application of Erich arch bars. J Oral Maxillofac Surg. 1995;53:1174–6.CrossRefPubMed
15.
go back to reference Hussain SA, Latif ABA, Choudhary AA. Risk to surgeons: a survey of accidental injuries during operations. Br J Surg. 1988;75:314.CrossRefPubMed Hussain SA, Latif ABA, Choudhary AA. Risk to surgeons: a survey of accidental injuries during operations. Br J Surg. 1988;75:314.CrossRefPubMed
17.
18.
go back to reference Hamer AJ. Electronic device for the detection of breaches in asepsis during surgical procedures. BrJ Surg. 1987;74:10389.CrossRef Hamer AJ. Electronic device for the detection of breaches in asepsis during surgical procedures. BrJ Surg. 1987;74:10389.CrossRef
20.
21.
go back to reference Tanner J, Parkinson H. Double gloving to reduce surgical cross-infection. Cochrane Database Syst Rev. 2006;3:CD003087. Tanner J, Parkinson H. Double gloving to reduce surgical cross-infection. Cochrane Database Syst Rev. 2006;3:CD003087.
22.
go back to reference Naver LP, Gottrup F. Incidence of glove perforations in gastrointestinal surgery and the protective effect of double gloves: a prospective, randomized controlled study. Eur J Surg. 2000;166:293–5.CrossRefPubMed Naver LP, Gottrup F. Incidence of glove perforations in gastrointestinal surgery and the protective effect of double gloves: a prospective, randomized controlled study. Eur J Surg. 2000;166:293–5.CrossRefPubMed
23.
go back to reference Sohn RL, Murray MT, Franko A, Hwang PK, Dulchavsky SA, Grimm MJ. Detection of surgical glove integrity. Am Surg. 2000;66(3):302–6.PubMed Sohn RL, Murray MT, Franko A, Hwang PK, Dulchavsky SA, Grimm MJ. Detection of surgical glove integrity. Am Surg. 2000;66(3):302–6.PubMed
24.
go back to reference Gani JS, Anseline PF, Bissett RL. Efficacy of double versus single gloving in protecting the operating room team. Aust NZ J Surg. 1990;60:171–5. Gani JS, Anseline PF, Bissett RL. Efficacy of double versus single gloving in protecting the operating room team. Aust NZ J Surg. 1990;60:171–5.
25.
go back to reference Abebe Bekele MD, Amezene Tadesse MD. Inadequate Hepatitis B vaccination among surgeons practicing in Ethiopia: a cross sectional study. Ethiop Med J. 2014;52(3):107–12.PubMed Abebe Bekele MD, Amezene Tadesse MD. Inadequate Hepatitis B vaccination among surgeons practicing in Ethiopia: a cross sectional study. Ethiop Med J. 2014;52(3):107–12.PubMed
26.
go back to reference Meakin LB, Gilman OP, Parsons KJ, Burton NJ, Langley‐Hobbs SJ. Colored indicator undergloves increase the detection of glove perforations by surgeons during small animal orthopedic surgery: a randomized controlled trial. Vet Surg. 2016;45(6):709–14. doi:10.1111/vsu.12519.CrossRefPubMedPubMedCentral Meakin LB, Gilman OP, Parsons KJ, Burton NJ, Langley‐Hobbs SJ. Colored indicator undergloves increase the detection of glove perforations by surgeons during small animal orthopedic surgery: a randomized controlled trial. Vet Surg. 2016;45(6):709–14. doi:10.​1111/​vsu.​12519.CrossRefPubMedPubMedCentral
Metadata
Title
Incidence and patterns of surgical glove perforations: experience from Addis Ababa, Ethiopia
Authors
Abebe Bekele
Nardos Makonnen
Lidya Tesfaye
Mulat Taye
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2017
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-017-0228-8

Other articles of this Issue 1/2017

BMC Surgery 1/2017 Go to the issue