title: Bacterial migration through punctured surgical gloves under real surgical conditions.
abstract: BACKGROUND
  The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions.
  
  
  METHODS
  An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel double-gloving surgical gloves were used during visceral surgeries over a 6-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.
  
  
  RESULTS
  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% with a median wearing time of 100 minutes (range: 20-175 minutes). Perforations occurred in 81% on the non-dominant hand, with the index finger most frequently (25%) punctured. In six cases, bacterial migration could be demonstrated microbiologically. In 5% (5/98) of outer gloves and in 1% (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% (n = 5). The minimum wearing time was 62 minutes, with a calculated median wearing time of 71 minutes.
  
  
  CONCLUSIONS
  This study confirms previous results that bacterial migration through unnoticed micro-perforations in surgical gloves does occur under real practical surgical conditions. Undetected perforation of surgical gloves occurs frequently. 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.
authors.affiliation: Institute of Hygiene and Environmental Medicine, Ernst-Moritz-Arndt University, Greifswald, Germany. nhuebner@uni-greifswald.de
authors.forename: Nils-Olaf
authors.initials: NO
authors.lastname: Hübner
authors.forename: Anna-Maria
authors.initials: AM
authors.lastname: Goerdt
authors.forename: Natalie
authors.initials: N
authors.lastname: Stanislawski
authors.forename: Ojan
authors.initials: O
authors.lastname: Assadian
authors.forename: Claus-Dieter
authors.initials: CD
authors.lastname: Heidecke
authors.forename: Axel
authors.initials: A
authors.lastname: Kramer
authors.forename: Lars Ivo
authors.initials: LI
authors.lastname: Partecke
mesh_terms: D001419:Bacteria / Q000302:isolation & purification*; D001424:Bacterial Infections / Q000635:transmission*; D005932:Gloves, Surgical / Q000382:microbiology*; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000706:statistics & numerical data*; D011446:Prospective Studies