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Observational study on the occurrence of surgical glove perforation and associated risk factors in large animal surgery

OBJECTIVE
To determine the incidence of and associated risk factors for glove perforation in large animal surgery.


STUDY DESIGN
Prospective observational cohort study.


SAMPLE POPULATION
Surgical gloves (n = 917) worn during 103 large animal surgical procedures.


METHODS
Gloves worn by personnel involved in sterile preparation and surgical procedures were tested for perforation by 2 previously validated methods, water leak test (WLT) and electroconductivity testing (ECT). The association between surgical and glove-related variables and glove perforation was assessed by using a multivariable mixed-effect logistic regression model.


RESULTS
At least 1 glove perforation was detected in 66% of surgical procedures, and 17.9% (164/917) of gloves tested were identified as perforated. All perforations were detected by ECT, whereas only 110/178 (61.8%) were detected by WLT. All perforations detected by WLT were also detected by ECT. The risk of glove perforation increased with duration of wear (>60 minutes odds ratio [OR] 2.3, 95% CI 1.4-3.7; P < .001) and with invasiveness of procedures (OR 7.9, 95% CI 3.2-19.5; P < .001). Primary surgeons were at higher risk for glove perforation than first (OR 1.7, 95% CI 1.1-2.5; P = .008) and second (OR 3.4, 95% CI 2-6.7; P < .001) assistants. Only 25% of glove perforations were detected intraoperatively by the wearer.


CONCLUSION
Incidence of glove perforation is similar in large animal, human, and small animal surgery and is influenced by duration of wear, invasiveness of the surgery, and role of the wearer. ECT is more sensitive than WLT for detection of glove perforation.