The efficacy of gloves in reducing blood volumes transferred during simulated needlestick injury was examined by Mast and others (J Infect Dis 1993). Glove material reduced the transferred blood volume by 46-86% (average 60%) in both models (18 gauge and 20 gauge needles).
Studies by Brough (Br J Surg 1998), Palmisano (Am Coll Card 1989), Matta (Br J Surg 1998), and Gerberding (N Eng J Med, 1990) examined surgical glove failures post-use with the water-fill test. The results were glove failure rates of 17.5% to 37.5% for single gloves versus 4.5% to 5.5% of the inner gloves during double gloving. The authors concluded that: 1) all surgical personnel are at risk for intraoperative exposure to blood and should therefore double glove; 2) double gloving prevented perforation of inner gloves and cutaneous exposure of the hand.
Quebbeman studied 284 surgeons and first assistants in a prospective randomized trial of procedures >2 hours and found glove failure rates (e.g. blood contamination of fingers) to be 51% for single gloves and 7% for double gloves. Conclusions of the study were 1) the longer the glove is worn the more likely it is to fail; 2) double gloving should be and can be used routinely during major surgical procedures to protect surgeons from blood contamination (Arch Surg 1992).
A cost-analysis of surgical gloves shows first generation gloves cost an average of $.60 and reliability is consistent with the 1.5% (i.e., the good manufacturing practice standards). Second generation gloves cost an average of $4.00 and reliability is 100% as guaranteed by manufacturer.
The Department of Hospital Epidemiology at the University of North Carolina Hospitals Recommendation: Double gloving should be allowed and recommended for certain high risk procedures when shearing of glove material is likely and contact with sharp edged items (e.g., orthopedic surgery) is common.
Steris has purchased the infection control component of ConvaTec (formerly Calgon-Vestal).
Recent publications in infection control include:
Weber DJ, Rutala WA, Hamilton H. Prevention and Control of Varicella-Zoster Infections in Healthcare Facilities. Infect Control Hosp Epidemiol 1996;16:694-705.
Weber DJ, Rutala WA, Denny FW. Management of Healthcare Workers With Pharyngitis of Suspected Streptococcal Infections. Infect Control Hosp Epidemiol 1996;16:753- 761.
Report of the Month is also available on the home page of the Statewide Infection Control Program at http://www.unc.edu/depts/spice/
The Statewide Infection Control Program (SICP) is funded by the General Assembly of North Carolina to serve the State. The SICP is not a regulatory agency but provides education and consultation to North Carolina healthcare facilities.