title: Microperforations of surgical gloves in urology: minimally invasive versus open surgeries.
abstract: BACKGROUND
  Surgical glove integrity is important in preventing wound infections and reducing patient mortality. Rates of perforations have been studied in many surgical subspecialties, but glove perforations specific to urology have not been investigated previously. This study aims to determine the incidence of glove perforations during urological surgeries and to investigate differences between open, laparoscopic, and endoscopic procedures.
  
  
  METHODS
  A total of 180 gloves were collected from various urological procedures performed at our institution: 59 from endoscopic, 72 from laparoscopic, and 49 from open cases. The gloves were tested for defects by both the water load test and electrical conductance testing. The frequency of defects for each type of procedure along with the length of wear, surgeon experience, and glove brand was analyzed.
  
  
  RESULTS
  Glove defects were detected in 29% of all cases. Microperforations encompassed the majority of the glove defects (23.3%) and were detected in 15.2%, 25.0 %, and 30.6% of the endoscopy, laparoscopic and open surgical cases, respectively. The frequency of perforations noted in the minimally invasive procedures was significantly different across the groups (p < 0.01). There was no statistical significant correlation between glove defects and operation time, surgeon experience, and glove brand.
  
  
  CONCLUSIONS
  The rates of glove perforation (29%) in urological procedures were higher than expected. Given the high rates of glove perforations found, double gloving in urological surgeries may offer a solution to the increased risk for cross contamination from microscopic perforations.
authors.affiliation: James Buchanan Brady Urological Institute, Department of Urology, Johns Hopkins Medical Institutions, Baltimore, MD 21230, USA.
authors.forename: Tom
authors.initials: T
authors.lastname: Feng
authors.forename: Jithin
authors.initials: J
authors.lastname: Yohannan
authors.forename: Angela
authors.initials: A
authors.lastname: Gupta
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Hyndman
authors.forename: Mohammad
authors.initials: M
authors.lastname: Allaf
mesh_terms: D000704:Analysis of Variance; D002983:Clinical Competence; D004868:Equipment Failure; D019544:Equipment Failure Analysis; D005932:Gloves, Surgical / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000706:statistics & numerical data*; D008422:Materials Testing; D013997:Time Factors; D013520:Urologic Surgical Procedures / Q000706:statistics & numerical data*