Punctured Surgical Gloves in Major Gynecologic Surgery: Does Surgical Experience of the Operator Make a Difference?

The use of one pair of surgical gloves as a protective barrier between physician and patient has been the accepted standard. The prevalence of intraoperative glove perforation ranges from 16% to 43% and is believed to increase the potential for wound sepsis and for accidental exposure of both patient and physician to human immunodeficiency virus (HIV) and hepatitis virus. To determine if surgical experience is significant in accidental glove perforation, we undertook a prospective study of 40 major obstetric and gynecologic operative procedures lasting longer than 60 minutes and associated with blood loss greater than 100 ml. Visible blood was identified on 21 hands in 18 cases: 5 staff physicians and 12 residents wearing single gloves and 2 residents wearing double gloves. In 2 cases, both single gloves were perforated. In one case both a single and double gloved hand were perforated. Sixteen perforations were on the left hand, and 14 of these involved the left index finger. The length of the procedure correlated positively with glove puncture. We recommend double gloving.