The most common surgical gloves used at the Royal Hobart Hospital are 'Individually Tested' (IT) gloves, in which each glove is tested for leaks by the manufacturer prior to sterilization and packaging. A cheaper brand of glove is available in which sample gloves from manufactured batches are tested for leaks (BT), but not each glove. The latter gloves were widely rejected by surgeons on the theoretical ground that there would be more perforations, and consequently more wound infection and greater exposure of staff to patient pathogens. However no objective study had been done to test this conjecture. The aims of this study were to compare the integrity of the two brands of gloves by mechanical and microbiological methods, and to compare the incidence of postoperative wound infection following the use of either brand. 110 unused gloves of each brand were tested for leaks. 318 IT and 278 BT gloves were then tested after clean surgery, for mechanical leaks. Scrub-team member's gloves and hands were cultured post-surgery. Wound infection rates were compared. The pre-use perforation rate was not significantly different. The macroperforation rate for if gloves was slightly but statistically significantly higher than for BT gloves, and no bias in types of operations or in staff members could be uncovered to account for this. Growth of normal skin flora was found on virtually every wearer's hands after removal of gloves, suggesting a failure of current scrub techniques or solutions to eliminate skin flora. Furthermore these bacteria were commonly cultured from the outside of the gloves at the conclusion of surgery, indicating development of microporosity of the glove-latex during surgery. There was a statistically significant difference in the glove outer-surface bacterial detection rates between the brands (BT>IT) indicating a difference in latex properties between brands. It is suggested that a standardized form of this test could be developed as a quality measure of surgical gloves. A final finding was the absence of translation of macroperforation rates or bacterial culture rates into morbidity as measured by wound infection. It could be concluded that for this type of surgery, the detected glove differences are irrelevant with regard to patient morbidity. However caution is suggested in extending these findings to situations of known patient infectivity (eg. HIV or viral hepatitis) or to cases where Am contamination could be a serious problem (eg. joint surgery or neurosurgery). The data adds weight to the strategy of double gloving.
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Copyright 2000 the Author - The University is continuing to endeavour to trace the copyright owner(s) and in the meantime this item has been reproduced here in good faith. We would be pleased to hear from the copyright owner(s). Thesis (M.Med.Sc.)--University of Tasmania, 2000. Includes bibliographical references