Incidence and patterns of surgical glove perforations: experience from Addis Ababa, Ethiopia.
BACKGROUND
Surgical glove perforation is a common event. The operating staff is not aware of the perforation until the procedure is complete, sometimes in as high as 70% of the incidences. Data from Ethiopia indicates that the surgical workforce suffers from a very surgery related accidents, however there is paucity of data regarding surgical glove perforation. The main objective is to describe the incidence and patterns of surgical glove perforation during surgical procedures and to compare the rates between emergency and elective surgeries at one of the main hospitals in Addis Ababa Ethiopia.


METHODS
This is a prospective study, performed at the Minilik II referral hospital, Addis Ababa. All surgical gloves worn during all major surgical procedures (Emergency and Elective) from June 1-July 20, 2016 were collected and used for the study. Standardised visual and hydro insufflation techniques were used to test the gloves for perforations. Parameters recorded included type of procedure performed, number of perforations, localisation of perforation and the roles of the surgical team.


RESULTS
A total of 2634 gloves were tested, 1588 from elective and 1026 from emergency procedures. The total rate of perforation in emergency procedures was 41.4%, while perforation in elective surgeries was 30.0%. A statistically significant difference (P < 0.05) was found in between emergency and elective surgeries. There were a very high rate of perforations of gloves among first surgeons 40.6% and scrub nurses 38.8% during elective procedures and among first surgeons (60.14%), and second assistants (53.0%) during emergency surgeries. Only 0.4% of inner gloves were perforated. The left hand, the left index finger and thumb were the most commonly perforated parts of the glove. Glove perforation rate was low among consultant surgeons than residents.


CONCLUSIONS
Our reported perforation rate is higher than most publications, and this shows that the surgical workforce in Ethiopia is under a clear and present threat. Measures such as double gloving seems to have effectively prevented cutaneous blood exposure and thus should become a routine for all surgical procedures. Manufacturing related defects and faults in glove quality may also be contributing factors.
School of Medicine, Addis Ababa University, PO BOX 3560, Addis Ababa, Ethiopia. abebesurg@yahoo.com.
Abebe
http://orcid.org/0000-0003-0018-9096
A
Bekele
Drexel University, Philadelphia, USA.
Nardos
N
Makonnen
School of Medicine, Addis Ababa University, PO BOX 3560, Addis Ababa, Ethiopia.
Lidya
L
Tesfaye
School of Medicine, Addis Ababa University, PO BOX 3560, Addis Ababa, Ethiopia.
Mulat
M
Taye
D017558:Elective Surgical Procedures / Q000295:instrumentation / Q000706:statistics & numerical data; D004630:Emergencies; D004868:Equipment Failure / Q000706:statistics & numerical data*; D005002:Ethiopia; D005932:Gloves, Surgical / Q000009:adverse effects* / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D011446:Prospective Studies; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*