title: Reducing accidental injuries during surgery.
abstract: Extensive clinical investigations have demonstrated that double-gloves and blunt-tipped surgical needles dramatically reduced the risk of accidental injuries during surgery. During the last decade, double-glove hole puncture indication systems have been developed that reduce the clinical risk of accidental needlestick injuries as well as detect the presence of glove hole puncture in the presence of fluids. When the outer glove is punctured, the colored underglove becomes apparent through the translucent outer glove, necessitating glove removal, hand washing, and donning of another double-glove hole puncture Indicator system. This article presents the first biomechanical performance study that documents the puncture resistance of blunt surgical needles in latex and nonlatex single gloves and double-glove hole puncture indication systems. The technique for measuring glove puncture resistance simulates the standard test for material resistance to puncture outlined by the American Society for Testing and Materials. The maximum puncture resistance force was measured by the compression load cell and recorded in grams with a strip chart recorder. Ten puncture resistance measurements for the taper point needle, blunt taper point needle, and blunt needle were taken from five samples of the Biogel Indicator underglove, Biogel Super-Sensitive glove, Biogel glove, Biogel Skinsense N Universal underglove, and Biogel Skinsense Polyisoprene glove; and the Biogel, Biogel Super-Sensitive, and Biogel Skinsense Polyisoprene double-glove hole puncture indication systems. The magnitude of puncture resistance forces recorded was influenced by several factors: glove material, number of glove layers, and type of surgical needle. For each type of curved surgical needle,the resistance to needle penetration by the nonlatex gloves was significantly greater than those encountered by the latex glove materials. The resistance to needle puncture of all three double-glove systems was significantly greater than that of either the nonlatex or latex underglove or outer glove. The taper point needle encountered the lowest puncture resistance forces in the five single gloves and the three double-glove systems. Blunting the sharp end of the taper point needle markedly increased its resistance to glove puncture in the five single gloves and five double-glove systems. The blunt-point surgical needle elicited the greatest needle penetration force in all of the single and double-glove systems.
authors.affiliation: Plastic Surgery Research Program, University of Virginia Health System, Charlottesville, Virginia, USA. redlich9@attbi.com
authors.forename: Richard F
authors.initials: RF
authors.lastname: Edlich
authors.forename: Tyler C
authors.initials: TC
authors.lastname: Wind
authors.forename: Lisa G
authors.initials: LG
authors.lastname: Hill
authors.forename: John G
authors.initials: JG
authors.lastname: Thacker
authors.forename: Walter
authors.initials: W
authors.lastname: McGregor
mesh_terms: D000062:Accidents, Occupational / Q000517:prevention & control*; D004867:Equipment Design; D013502:General Surgery; D005932:Gloves, Surgical; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D008422:Materials Testing; D009339:Needles; D016602:Needlestick Injuries / Q000517:prevention & control; D014947:Wounds and Injuries / Q000517:prevention & control*