Do Surgeons Wear Two Pairs of Gloves for Surgery? A Closer Look at Surgical Glove Practices
Yes, many surgeons routinely wear two pairs of surgical gloves during surgical procedures to minimize the risk of cross-contamination and infection. This practice, known as double gloving, provides an extra layer of protection against sharps injuries and the transmission of pathogens.
The Evolution of Surgical Gloving Practices
The history of surgical gloving has evolved significantly, moving from bare hands to single gloves and now, increasingly, to double gloving. Early surgical procedures were performed without any barrier protection, exposing both the patient and the surgical team to significant risks. The introduction of rubber gloves in the late 19th century marked a major advancement. However, single gloves, while providing some protection, were found to have a concerning rate of perforation during surgery, leading to the consideration of double gloving as a standard practice. The need for enhanced protection against bloodborne pathogens, such as HIV and hepatitis, further fueled the adoption of double gloving.
Benefits of Double Gloving
The primary benefit of double gloving is the reduction in the risk of cross-contamination between the surgeon and the patient. Studies have consistently shown that single gloves often develop perforations during surgery, sometimes without the surgeon even being aware. Double gloving offers several advantages:
- Reduced Risk of Perforation: The outer glove acts as a primary barrier, and if punctured, the inner glove provides a secondary layer of protection.
- Decreased Exposure to Bloodborne Pathogens: Even with a single glove perforation, the volume of blood transferred to the surgeon’s hands is significantly reduced with double gloving.
- Enhanced Tactile Sensation (Counterintuitively): Some surgeons report improved tactile sensation with certain double gloving systems, especially those utilizing colored gloves or specifically designed inner gloves.
- Reduced Risk of Surgical Site Infections (SSIs): By minimizing the chance of cross-contamination, double gloving can contribute to a lower rate of SSIs.
The Double Gloving Procedure
The process of double gloving is straightforward, but requires proper technique to ensure effectiveness. Here’s a typical sequence:
- Hand Hygiene: Perform a thorough surgical scrub according to established protocols.
- Don First Pair of Gloves: Don the first pair of sterile surgical gloves, using a sterile gloving technique.
- Don Second Pair of Gloves: Don the second pair of sterile surgical gloves over the first pair, again using a sterile gloving technique. Often, a different color glove is used as the outer layer to easily identify perforations.
- Glove Changing (if required): If a glove perforation is noticed, the outer glove should be removed and replaced immediately. This can be done with assistance to maintain sterility.
Evidence Supporting Double Gloving
Numerous studies have demonstrated the efficacy of double gloving in reducing glove perforations and exposure to bloodborne pathogens. A meta-analysis published in the British Journal of Surgery found that double gloving significantly reduced the risk of inner glove perforation compared to single gloving. Other studies have shown a correlation between double gloving and a decreased risk of surgical site infections. While the cost of using two gloves is higher, many institutions believe the benefits outweigh the expense, particularly when considering the potential costs associated with treating healthcare worker infections and SSIs. Considering this, the question ” Do Surgeons Wear Two Pairs of Gloves for Surgery?” is often answered with a resounding yes.
Different Types of Surgical Gloves
Several types of surgical gloves are available, each with its own properties and advantages. These include:
- Latex Gloves: Offer excellent elasticity and tactile sensitivity but can cause allergic reactions in some individuals.
- Nitrile Gloves: A synthetic alternative to latex, providing good puncture resistance and chemical resistance.
- Neoprene Gloves: Another synthetic option, known for its comfort and elasticity.
- Powdered vs. Powder-Free Gloves: Powder-free gloves are now preferred due to concerns about powder-related complications, such as granuloma formation and allergic reactions.
The material choice is crucial for all surgical staff.
Addressing Concerns About Dexterity
One common concern about double gloving is the potential for reduced dexterity. While some surgeons initially experience a slight decrease in tactile sensation, studies have shown that with practice, this can be overcome. Furthermore, specialized double gloving systems, such as those with thinner inner gloves or colored puncture indication systems, are designed to minimize any impact on dexterity.
Common Mistakes to Avoid
- Using Incorrect Sizing: Wearing gloves that are too tight or too loose can increase the risk of perforation and decrease dexterity.
- Improper Gloving Technique: Failing to use proper sterile gloving technique can compromise the sterility of the gloves.
- Ignoring Glove Perforations: Not promptly addressing glove perforations can negate the benefits of double gloving.
- Not Changing Gloves When Needed: Gloves should be changed if there’s a concern about contamination, even if no perforation is apparent.
The Future of Surgical Gloving
Research is ongoing to develop even more effective surgical glove technologies, including self-sealing gloves and gloves with antimicrobial properties. These advancements aim to further reduce the risk of cross-contamination and infection in the operating room. The fundamental need addressed by asking ” Do Surgeons Wear Two Pairs of Gloves for Surgery?” will continue to be a driving force for innovation.
Frequently Asked Questions (FAQs)
Are there any disadvantages to double gloving?
Yes, while the advantages of double gloving are substantial, there are some potential downsides. These include the increased cost of using two gloves per procedure and the initial adjustment period for some surgeons to adapt to the altered tactile sensation. However, most studies suggest these disadvantages are outweighed by the benefits of reduced infection risk.
Does double gloving really reduce the risk of infection?
Absolutely. Studies have consistently demonstrated that double gloving significantly reduces the risk of inner glove perforation and, consequently, the exposure of healthcare workers and patients to bloodborne pathogens. This, in turn, contributes to a lower risk of surgical site infections.
What is the best type of glove to use for double gloving?
The best type of glove for double gloving depends on individual preferences and institutional policies. Nitrile gloves are often preferred due to their puncture resistance and lack of latex allergens. Many institutions also use colored indicator systems where the inner glove is a different color to aid in perforation detection.
How often do single gloves perforate during surgery?
The rate of single glove perforation varies depending on the type of surgery, the surgeon’s experience, and the quality of the gloves. Studies have reported perforation rates ranging from 5% to over 20%.
How do I know if my glove is perforated?
Small glove perforations can be difficult to detect visually. Some double gloving systems use colored indicator systems where the inner glove is a different color, making perforations more visible. Regular inspection of gloves during surgery is also crucial.
Is double gloving mandatory in all surgical procedures?
While not universally mandated, double gloving is strongly recommended by many professional organizations and is becoming increasingly common as a standard practice. Some institutions have policies requiring double gloving for specific high-risk procedures.
What is “glove perforation awareness”?
Glove perforation awareness refers to a surgeon’s ability to detect glove perforations during surgery. Some surgeons are unaware of perforations in their gloves, highlighting the importance of double gloving as a protective measure. Education and training can improve glove perforation awareness.
Can I use two pairs of the same size gloves for double gloving?
It is generally recommended to wear a slightly larger size for the outer glove to avoid restricting movement and compromising dexterity.
Are there special gloves designed for double gloving?
Yes, several manufacturers offer specialized double gloving systems, often with thinner inner gloves and colored indicator systems.
What if I am allergic to latex?
Nitrile and neoprene gloves are excellent latex-free alternatives. They offer similar levels of protection and comfort.
What happens if I detect a perforation in my glove during surgery?
The perforated glove should be removed and replaced immediately, maintaining strict sterile technique. This may require assistance from a scrub nurse or other member of the surgical team.
Should all members of the surgical team double glove, or just the surgeon?
Ideally, all members of the surgical team who are directly involved in the surgical procedure should double glove. This includes scrub nurses, surgical technicians, and other assistants who may come into contact with the patient’s blood or body fluids. Answering the question ” Do Surgeons Wear Two Pairs of Gloves for Surgery?” should be, ideally, the whole team.