title: Removing Outer Gloves as a Method to Reduce Spinal Surgery Infection.
abstract: METHODS
  A retrospective cohort study was performed to analyze the effect of a specifically timed glove change on infection rates in lumbar spinal fusion.
  
  
  OBJECTIVE
  Postoperative infection is a frequent and taxing complication following posterior lumbar spine fusion with instrumentation. This procedure is associated with infection rates up to 9%. The most common organism responsible for infection is Staphylococcus aureus which, along with many of the other common causative organisms, is often part human skin flora. This implicates the surgeon's gloves as the mode of transfer for these organisms from the patient's skin to the wound. The authors conducted a retrospective study to determine if a simple glove change before handling instrumentation could significantly reduce the rate of postoperative infection for this procedure.
  
  
  METHODS
  A total of 389 patients requiring lumbar spine fusion were enrolled retrospectively and divided into 2 groups: a control group of 179 patients treated with standard protocol for the procedure (group A) and a treatment group of 210 patients in whom, after initially double gloving, the outer pair of gloves was removed before handling the instrumentation. Infection rates were compared up to 1 year postoperatively.
  
  
  RESULTS
  There was a statistically significant reduction of infection rate from 3.35% in group A (control) to 0.48% in group B (P=0.0369).
  
  
  CONCLUSIONS
  This study shows that the removal of an outer pair of gloves before handling instrumentation may be a simple, cost-effective, and practical way to reduce the burden of postoperative infection following lumbar spinal fusion.
authors.affiliation: *Aga Khan Medical University, Karachi, Pakistan †Department of Neurosurgery, King Fahd Specialists Hospital, Al-Qassim, Saudi Arabia ‡Department of Neurosurgery, St. Francis Medical Center, Topeka, KS.
authors.forename: Amina
authors.initials: A
authors.lastname: Rehman
authors.forename: Atiq-Ur
authors.initials: AU
authors.lastname: Rehman
authors.forename: Tausif-Ur
authors.initials: TU
authors.lastname: Rehman
authors.forename: Casey
authors.initials: C
authors.lastname: Freeman
mesh_terms: D015331:Cohort Studies; D005932:Gloves, Surgical; D006801:Humans; D019635:Neurosurgical Procedures; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*; D013203:Staphylococcal Infections / Q000517:prevention & control; D013525:Surgical Instruments; D013530:Surgical Wound Infection / Q000517:prevention & control*