Published 10/1/2013
Calin S. Moucha, MD

Safety First

Infection prevention tips

Did you know that double-gloving has been shown to reduce blood contact to the hands of the operating team members by nearly 90 percent?

The risk of contamination from blood can be 13 times higher when using single compared with double gloves, and double indicator gloves (gloves with a puncture indicator system) appear to be better than two regular gloves.

Double-gloving, interestingly, has shown a similar incidence of wound contamination when compared to single-gloving. Several studies, in fact, have shown that triple gloving with a cloth glove between two latex gloves may be the best barrier of all during arthroplasty procedures. This practice, however, is more expensive and may reduce manual dexterity.

Considering that double-gloving does not significantly affect manual dexterity or tactile sensitivity when compared with single-gloving, it appears reasonable to recommend double-gloving for most orthopaedic cases in which glove perforation is likely to occur. The puncture rate of gloves increases in longer procedures, and systematic glove changes during key phases of certain procedures, such as hip arthroplasty, do reduce the frequency of occult perforations and bacterial loading of glove surfaces. Scrub-staff–assisted donning of gloves should be done whenever possible because it appears to lead to less gown contamination.

Infection prevention—always be in the know.

Calin S. Moucha, MD, is an assistant professor of orthopaedics and associate chief of joint replacement surgery in the Peter and Leni May department of orthopaedic surgery at Mt. Sinai Hospital in New York City.