Glove perforations during open surgery for gynaecological malignancies

A. P. Manjunath, J. H. Shepherd, D. P J Barton, J. E. Bridges, T. E J Ind

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objective: To audit glove perforations at laparotomies for gynaecological cancers. Setting: Gynaecological oncology unit, cancer centre, London. Design: Prospective audit. Sample: Twenty-nine laparotomies for gynaecological cancers over 3 months. Methods: Gloves used during laparotomies for gynaecological cancer were tested for perforations by the air inflation and water immersion technique. Parameters recorded were: type of procedure, localisation of perforation, type of gloves, seniority of surgeon, operation time and awareness of perforations. Main outcome measure: Glove perforation rate. Results: Perforations were found in gloves from 27/29 (93%) laparotomies. The perforation rate was 61/462 (13%) per glove. The perforation rate was three times higher when the duration of surgery was more than 5 hours. The perforation rate was 63% for primary surgeons, 54.5% for first assistant, 4.7% for second assistant and 40.5% for scrub nurses. Clinical fellows were at highest risk of injury (94%). Two-thirds of perforations were on the index finger or thumb. The glove on the nondominant hand had perforations in 54% of cases. In 50% of cases, the participants were not aware of the perforations. There were less inner glove perforations in double gloves compared with single gloves (5/139 versus 26/154; P = 0.0004, OR = 5.4, 95% CI 1.9-16.7). The indicator glove system failed to identify holes in 44% of cases. Conclusions: Glove perforations were found in most (93%) laparotomies for gynaecological malignancies. They are most common among clinical fellows, are often unnoticed and often not detected by the indicator glove system.

Original languageEnglish
Pages (from-to)1015-1019
Number of pages5
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Volume115
Issue number8
DOIs
Publication statusPublished - 01-07-2008
Externally publishedYes

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Gynecologic Surgical Procedures
Laparotomy
Neoplasms
Thumb
Economic Inflation
Immersion
Fingers
Hand
Nurses
Air
Outcome Assessment (Health Care)
Water
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynaecology

Cite this

Manjunath, A. P. ; Shepherd, J. H. ; Barton, D. P J ; Bridges, J. E. ; Ind, T. E J. / Glove perforations during open surgery for gynaecological malignancies. In: BJOG: An International Journal of Obstetrics and Gynaecology. 2008 ; Vol. 115, No. 8. pp. 1015-1019.
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abstract = "Objective: To audit glove perforations at laparotomies for gynaecological cancers. Setting: Gynaecological oncology unit, cancer centre, London. Design: Prospective audit. Sample: Twenty-nine laparotomies for gynaecological cancers over 3 months. Methods: Gloves used during laparotomies for gynaecological cancer were tested for perforations by the air inflation and water immersion technique. Parameters recorded were: type of procedure, localisation of perforation, type of gloves, seniority of surgeon, operation time and awareness of perforations. Main outcome measure: Glove perforation rate. Results: Perforations were found in gloves from 27/29 (93{\%}) laparotomies. The perforation rate was 61/462 (13{\%}) per glove. The perforation rate was three times higher when the duration of surgery was more than 5 hours. The perforation rate was 63{\%} for primary surgeons, 54.5{\%} for first assistant, 4.7{\%} for second assistant and 40.5{\%} for scrub nurses. Clinical fellows were at highest risk of injury (94{\%}). Two-thirds of perforations were on the index finger or thumb. The glove on the nondominant hand had perforations in 54{\%} of cases. In 50{\%} of cases, the participants were not aware of the perforations. There were less inner glove perforations in double gloves compared with single gloves (5/139 versus 26/154; P = 0.0004, OR = 5.4, 95{\%} CI 1.9-16.7). The indicator glove system failed to identify holes in 44{\%} of cases. Conclusions: Glove perforations were found in most (93{\%}) laparotomies for gynaecological malignancies. They are most common among clinical fellows, are often unnoticed and often not detected by the indicator glove system.",
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Glove perforations during open surgery for gynaecological malignancies. / Manjunath, A. P.; Shepherd, J. H.; Barton, D. P J; Bridges, J. E.; Ind, T. E J.

In: BJOG: An International Journal of Obstetrics and Gynaecology, Vol. 115, No. 8, 01.07.2008, p. 1015-1019.

Research output: Contribution to journalArticle

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AU - Shepherd, J. H.

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N2 - Objective: To audit glove perforations at laparotomies for gynaecological cancers. Setting: Gynaecological oncology unit, cancer centre, London. Design: Prospective audit. Sample: Twenty-nine laparotomies for gynaecological cancers over 3 months. Methods: Gloves used during laparotomies for gynaecological cancer were tested for perforations by the air inflation and water immersion technique. Parameters recorded were: type of procedure, localisation of perforation, type of gloves, seniority of surgeon, operation time and awareness of perforations. Main outcome measure: Glove perforation rate. Results: Perforations were found in gloves from 27/29 (93%) laparotomies. The perforation rate was 61/462 (13%) per glove. The perforation rate was three times higher when the duration of surgery was more than 5 hours. The perforation rate was 63% for primary surgeons, 54.5% for first assistant, 4.7% for second assistant and 40.5% for scrub nurses. Clinical fellows were at highest risk of injury (94%). Two-thirds of perforations were on the index finger or thumb. The glove on the nondominant hand had perforations in 54% of cases. In 50% of cases, the participants were not aware of the perforations. There were less inner glove perforations in double gloves compared with single gloves (5/139 versus 26/154; P = 0.0004, OR = 5.4, 95% CI 1.9-16.7). The indicator glove system failed to identify holes in 44% of cases. Conclusions: Glove perforations were found in most (93%) laparotomies for gynaecological malignancies. They are most common among clinical fellows, are often unnoticed and often not detected by the indicator glove system.

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