Bacterial Migration Through Glove Micro-Perforations

Nils-Olaf Hübner, of the Institute of Hygiene and Environmental Medicine at Ernst-Moritz-Arndt University in Greifswald, Germany, and colleagues sought to confirm recent results from a previous study focusing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real-world surgical conditions. Their research was published in BMC Infectious Diseases.

The researchers note, "During surgery, intact surgical gloves act as a physical barrier against the transmission of bloodborne pathogens from hospital staff to patients and vice versa. Several studies demonstrated that unrecognized perforations of surgical gloves are not uncommon and that the frequency of defective gloves increases with duration of wear. It was also shown that the risk of perforations depends on the type of surgery performed, ranging from 7 percent in urological surgery up to 65 percent in cardiac surgery. In a previous study, we established a method to evaluate the quantity of bacteria passing through undiscovered glove punctures under real surgical conditions. We demonstrated that during surgery, micro-perforations allow the passage of large quantities of bacteria from the surgical site through the punctures. The purpose of this prospective investigation was to confirm our previously published results on bacterial translocations."

The researchers report that an established method was applied to detect bacterial migration from the operating site through the punctured glove. Double-gloving surgical gloves were used during visceral surgeries over a six-month period. A modified Gaschen-bag method was used to retrieve organisms from the inner glove, and thus-obtained bacteria were compared with micro-organisms detected by an intra-operative swab.

Hubner, et al. (2010) reports that in 20 consecutive procedures, 194 gloves (98 outer gloves, 96 inner gloves) were examined. The rate of micro-perforations of the outer surgical glove was 10 percent with a median wearing time of 100 minutes (range: 20 to 175 minutes). Perforations occurred in 81 percent on the non-dominant hand, with the index finger most frequently (25 percent) punctured. In six cases, bacterial migration could be demonstrated microbiologically. In 5 percent (5/98) of outer gloves and in 1 percent (1/96) of the inner gloves, bacterial migration through micro-perforations was observed. For gloves with detected micro-perforations (n = 10 outer layers), the calculated migration was 50 percent (n = 5). The minimum wearing time was 62 minutes, with a calculated median wearing time of 71 minutes.

The researchers conclude that their study confirms previous results that bacterial migration through unnoticed micro-perforations in surgical gloves does occur under real practical surgical conditions. They add that undetected perforation of surgical gloves occurs frequently. They say that bacterial migration from the patient through micro-perforations on the hand of surgeons was confirmed, limiting the protective barrier function of gloves if worn over longer periods.

Reference: Hübner NO, Goerdt AM, Stanislawski N, Assadian O, Heidecke CD, Kramer A and ParteckeLI. Bacterial migration through punctured surgical gloves under real surgical conditions. BMC Infectious Diseases 2010, 10:192doi:10.1186/1471-2334-10-192