RT Journal
A1 Misteli H, Weber WP, Reck S, et al
T1 SUrgical glove perforation and the risk of surgical site infection
JF Archives of Surgery
JO Archives of Surgery
YR 2009
FD June 1
VO 144
IS 6
SP 553
OP 558
DO 10.1001/archsurg.2009.60
UL http://dx.doi.org/10.1001/archsurg.2009.60
AB Hypothesis 
    Clinically apparent surgical glove perforation increases the risk of surgical site infection (SSI).Design 
    Prospective observational cohort study.Setting 
    University Hospital Basel, with an average of 28 000 surgical interventions per year.Participants 
    Consecutive series of 4147 surgical procedures performed in the Visceral Surgery, Vascular Surgery, and Traumatology divisions of the Department of General Surgery.Main Outcome Measures 
    The outcome of interest was SSI occurrence as assessed pursuant to the Centers of Disease Control and Prevention standards. The primary predictor variable was compromised asepsis due to glove perforation.Results 
    The overall SSI rate was 4.5% (188 of 4147 procedures). Univariate logistic regression analysis showed a higher likelihood of SSI in procedures in which gloves were perforated compared with interventions with maintained asepsis (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.4-2.8; P < .001). However, multivariate logistic regression analyses showed that the increase in SSI risk with perforated gloves was different for procedures with vs those without surgical antimicrobial prophylaxis (test for effect modification, P = .005). Without antimicrobial prophylaxis, glove perforation entailed significantly higher odds of SSI compared with the reference group with no breach of asepsis (adjusted OR, 4.2; 95% CI, 1.7-10.8; P = .003). On the contrary, when surgical antimicrobial prophylaxis was applied, the likelihood of SSI was not significantly higher for operations in which gloves were punctured (adjusted OR, 1.3; 95% CI, 0.9-1.9; P = .26).Conclusion 
    Without surgical antimicrobial prophylaxis, glove perforation increases the risk of SSI.