Running Head: 1

Why is it so important to establish a standard for every operating room personnel to start

double-gloving during surgical procedures? Research has shown that health care workers who

make it a practice to double-glove have significantly reduced their risk of contracting pathogens

such as HIV and hepatitis B. Research also revealed that there were several factors that

contributed to the failures of gloves and these factors include mechanical stress on gloves, type

of surgery performed, number of instruments used during the procedure, the wearer’s role in the

procedure and the length of time the procedure took (Thomas-Copeland, 2009).

There are a number of factors in the OR that act as stressors on gloves that may influence

their effectiveness in performance and protection. One mechanical stressor is the type of surgery

that is being performed. Studies have shown that glove perforation rates during surgical

procedures vary anywhere from 22% to 61%. According to an article written by Dr. Ramon

Berguer, Preventing Sharps Injuries in the Operating Room, the highest incidences (61%) were

reported in orthopedic trauma and thoracic surgeries because surgeons in these fields dealt with

sharp, fractured bones or bony structures (Thomas-Copeland, 2009). There was also a trend that

showed that surgeries that involved more instruments are associated with a higher glove failure

rate.

Research has also identified significant differences in glove failure rates in relation to the

role of the wearer in the surgical procedure. These studies have determined that surgeons have

the highest risk for glove failure citing rates as high as 30% and assistants following with 21%

(Thomas-Copeland, 2009). Many of these failures go unnoticed until after the surgical
procedure when the gloves are removed and blood is seen on the hands. The index finger of the

left hand of the surgeon is the most prone part of the gloves to be punctured or cut. The second

most common place to fail is the left thumb of the surgeon. The reason for the higher incidences

in these areas are due to the fact that most surgeons are right-handed and hold the instrument in

their dominant hand and accidentally puncture the glove of the opposite hand.

The length of time for a surgical procedure is also important in the performance of

surgical gloves. According to Ronald St. Germaine, surgeries that last for more than two hours

have glove defect incidences as high as 56% whereas surgeries that last less than two hours have

incidences of 20%. One study conducted even suggested that the risk of glove perforation

increases 1.115 times for every 10 minutes of surgical time (Thomas-Copeland, 2009). And

perforations are higher for emergency procedures as opposed to scheduled surgeries.

The evidence for the use of double-gloves is strong and compelling. In a 1992 study

reported by E.J. Quebbeman showed that incidence of contamination by personnel wearing only

single gloves reached as high as 51% compared to 7% by those who wore double gloves

(Thomas-Copeland, 2009). Although change is difficult to implement, mainly due to anticipated

change in tactile sensitivity, research by Quebbeman has shown that 88% of those who double-

gloved reported no change in tactile sensitivity. So, we go back to the question: To double-glove

or not to double-glove? History and research speaks for itself on this long standing issue, double

gloving provides further protection for the surgical team.

 References

Thomas-Copeland, J. (2009). Do surgical personnel really need to double-glove?. AORN

Journal, 89(2), 322-332. Retrieved from CINAHL Plus with Full Text database