title: Colored Indicator Undergloves Increase the Detection of Glove Perforations by Surgeons During Small Animal Orthopedic Surgery: A Randomized Controlled Trial.
abstract: OBJECTIVE
  To determine whether use of colored indicator gloves affects perforation detection rate and to identify risk factors for glove perforation during veterinary orthopedic surgery.
  
  
  METHODS
  Prospective randomized controlled trial.
  
  
  METHODS
  574 double pairs of gloves worn during 300 orthopedic surgical procedures (2,296 gloves).
  
  
  METHODS
  Primary and assistant surgeons double-gloved for all orthopedic surgical procedures. Type of inner glove (standard or colored indicator) was randomized for the first 360 double pairs of gloves worn by surgeons during 180 procedures. Perforations detected by surgeons were recorded and gloves changed if requested. For a further 120 procedures, indicator gloves were used exclusively. All gloves were leak-tested after surgery to identify perforations. Association between potential risk factors and perforation was explored using multivariate logistical regression analysis.
  
  
  RESULTS
  Glove perforations occurred during 43% of surgeries with a mean of 2.3 holes/surgery. Inner gloves were intact in 63% of glove pairs where an outer perforation occurred. Intraoperative perforation detection was improved when colored indicator gloves were worn (83% sensitivity) vs. standard gloves (34% sensitivity; P<.001). Independent risk factors for perforation were placement of plates and/or screws (P=.001; OR=2.4; 95% CI, 1.4-4.0), placement of an external skeletal fixator (P=.002; OR=7.0; 95% CI, 2.1-23.8), use of orthopedic wire (P=.011; OR=2.4; 95% CI, 1.2-4.7), and primary surgeon being board-certified (P=.016; OR=1.9; 95% CI, 1.1-3.1).
  
  
  CONCLUSIONS
  Increased surgeon recognition of glove perforations through use of colored indicator gloves enables prompt change of gloves if perforation occurs and may reduce potential contamination of the surgical site.
authors.affiliation: School of Veterinary Science, University of Bristol, Bristol, United Kingdom.
authors.forename: Lee B
authors.identifier: http://orcid.org/0000-0002-2161-9414
authors.initials: LB
authors.lastname: Meakin
authors.affiliation: School of Veterinary Science, University of Bristol, Bristol, United Kingdom.
authors.forename: Oliver P
authors.initials: OP
authors.lastname: Gilman
authors.affiliation: School of Veterinary Science, University of Bristol, Bristol, United Kingdom.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Parsons
authors.affiliation: School of Veterinary Science, University of Bristol, Bristol, United Kingdom.
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Burton
authors.affiliation: School of Veterinary Science, University of Bristol, Bristol, United Kingdom.
authors.forename: Sorrel J
authors.initials: SJ
authors.lastname: Langley-Hobbs
mesh_terms: D000818:Animals; D003428:Cross Infection / Q000517:prevention & control; D004868:Equipment Failure; D005932:Gloves, Surgical; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000517:prevention & control; D019637:Orthopedic Procedures / Q000662:veterinary*; D009985:Orthopedics; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D066231:Surgeons; D013522:Surgery, Veterinary