A prospective study on the risk of glove fingertip contamination during draping in joint replacement surgery

• Published in: Annals of the Royal College of Surgeons of England 2014-09, Vol.96 (6), p.434-436
• Main Authors: Makki, D, Deierl, K, Pandit, A, Trakru, S
• Format: Article
• Language: English
• Subjects: Arthroplasty, Replacement; Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Bacteria - isolation & purification; Clinical Competence; Consultants; England; Equipment Contamination - statistics & numerical data; Fingers & toes; Functional Laterality; Gloves; Gloves, Surgical - microbiology; Hands; Humans; Infectious Disease Transmission, Professional-to-Patient - prevention & control; Joint surgery; Medical Staff, Hospital; Orthopaedic Surgery; Prospective Studies; Risk Factors; Surgeons; Surgery; Surgical Drapes - microbiology
• ISSN: 0035-8843; 1478-7083
• DOI: 10.1308/003588414X13946184902046

The aim of this prospective study was to investigate the risk of contamination of surgical gloves during preparation and draping in joint replacement surgery. During 46 hip and knee replacement procedures, the gloves of orthopaedic consultants (n=5) and registrars (n=3) were assessed for contamination immediately after draping by impression of gloved fingers on blood agar. Contamination was evaluated by the surgeon's grade, the type of procedure, the role of the assistant and the dominance of the hand. A total of 125 pairs of top gloves were examined (79 pairs from registrars and 46 pairs from consultants). Bacterial contamination was isolated on 19 pairs (15.2%) (16 pairs from registrars and 3 pairs from consultants, p=0.04). Coagulase negative staphylococci were the main isolates and contamination was considered low in all cases (1-5 colonies). Contamination was seen more on the dominant hand (16 gloves from dominant hands and 6 from non-dominant hands, p=0.04), on the index finger and thumb. More contaminated gloves were seen in hip arthroplasty procedures (16 pairs from total hip replacements vs 3 pairs from total knee replacements, p=0.02). Contamination of glove fingertips during draping in joint replacement procedures is more likely to occur among junior surgeons, in hip rather than knee arthroplasty procedures and on the dominant hand. It is therefore essential that surgeons of different grades replace gloves used in draping to avoid exposing patients to the risk of infection.