title: Glove perforations during open surgery for gynaecological malignancies.
abstract: OBJECTIVE
  To audit glove perforations at laparotomies for gynaecological cancers.
  
  
  METHODS
  Gynaecological oncology unit, cancer centre, London.
  
  
  METHODS
  Prospective audit.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Gynecologic Oncology, Royal Marsden Hospital, London, UK. manjunath.ap@manipal.edu
authors.forename: A P
authors.initials: AP
authors.lastname: Manjunath
authors.forename: J H
authors.initials: JH
authors.lastname: Shepherd
authors.forename: D P J
authors.initials: DP
authors.lastname: Barton
authors.forename: J E
authors.initials: JE
authors.lastname: Bridges
authors.forename: T E J
authors.initials: TE
authors.lastname: Ind
mesh_terms: D004868:Equipment Failure; D005260:Female; D005833:Genital Neoplasms, Female / Q000601:surgery*; D005932:Gloves, Surgical / Q000592:standards* / Q000706:statistics & numerical data; D013509:Gynecologic Surgical Procedures / Q000295:instrumentation* / Q000706:statistics & numerical data; D006801:Humans; D007813:Laparotomy / Q000295:instrumentation* / Q000706:statistics & numerical data; D008485:Medical Audit; D011446:Prospective Studies; D013997:Time Factors