Prevalence and patterns of surgical glove perforations during orthopedic surgeries at Mulago National Referral Hospital

Abstract

Introduction: Surgical glove perforations predispose both the operating personnel and patients to cross infection emanating from blood during a surgical procedure. Despite observing glove protocols in utility of surgical gloves during orthopaedic surgeries at MNRH, we cannot appreciate the gravity of this risk without local evidence. General Objective: To determine the prevalence, patterns and factors associated with surgical glove perforations in Orthopedic surgical procedures done at MNRH. Methodology: This was a cross-sectional study done in the Orthopedic theatres of MNRH that included A&E, Ward 7 and Trauma Ward. At each operation, consent was obtained from the surgical team personnel. A total of 2001 used surgical gloves after orthopaedic surgical procedures were enrolled for the study by consecurtive sampling technique. Surgical gloves used were collected and tested for perforations. Obvious perforations were registered upon direct visual inspections while small and micro perforations were registered using the Water Leak Test. An assumption that all surgical gloves used in the surgical procedures for the study was used. Results The total number of procedures from the sample was realized was 135 orthopaedic procedures(89 major and 46 minor). The study found an overall prevalence of surgical glove perforations in orthopaedic surgery at MNRH to be 9.09%. Most perforations were found on bthe palmar aspect(64.8%);these were discovered on surgical gloves previously donned by the dominant hand. The major factors associated with surgical glove perforations were being a lead surgeon and major surgery. Conclusion The prevalence of surgical glove perforations during orthopaedic surgeries at MNRH is 9.09%, most perforations occur on the palmar aspect of surgical glove used by the dominant hand ;the thumb and index finger most at risk. Being a lead surgeon and participating in major surgery predispose to a significant risk of surgical glove perforations.