GLOVE TEARS AND SHARP INJURIES IN THE OPERATING ROOM
Concern about occupational exposure to HIV has increased interest in the epidemiology of risk in the operating room. To learn more about how exposures happen, researchers at Yale-New Haven Hospital had nurses interview operating-room personnel immediately after a possible exposure occurred.
During the three-month study period, in which there were 2292 surgical procedures, 249 personnel had visible glove tears; 92 percent of them were wearing only one pair of gloves, and no mechanism for the tear could be identified in 67 percent of instances. There were 70 sharp injuries: 67 percent by needles, 10 percent by scalpels, and 23 percent by other instruments. The researchers identified three common mechanisms of injury: in 16 percent of cases, hands were injured, while stationary and holding an instrument, by a sharp instrument passed into or out of the field. In 17 percent, hands were injured while being used to retract tissue. Several injuries were caused by sharp instruments not in use, such as needles in needle holders; the researchers believed that many of these instruments should have been removed from the surgical field.
These data suggest that many sharp injuries can be prevented by modifying standard operating-room procedures, and that glove tears might be reduced through design changes and use of double gloves.
— THL
Published in Journal Watch General Medicine October 4, 1991
Citation(s):
Wright JG et al. Mechanisms of glove tears and sharp injuries among surgical personnel. JAMA 1991 Sep 25 266 1668-1671.
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Operating rooms are sterile environments; all personnel wear protective clothing called scrubs. They also wear shoe covers, masks, caps, eye shields, and other coverings to prevent the spread of germs. The operating room is brightly lit and the temperature is very cool; operating rooms are air-conditioned to help prevent infection.
One of those sterile protective covering that is used for the hands is the gloves. Sterile gloves is a must in the operating room for the protection on the health care provider. Tearing of the gloves should be avoided as possible for the risk of infection. Aseptic technique is most strictly applied in the operating room because of the direct and often extensive disruption of skin and underlying tissue. Aseptic technique helps to prevent or minimize postoperative infection.
The instruments used during a surgical procedure are different for external and internal treatment; the same tools are not used on the outside and inside of the body. Once internal surgery is started, the surgeon uses smaller, more delicate devices.
Sterile surgical clothing or protective devices such as gloves, face masks, goggles, and transparent eye/face shields serve as barriers against microorganisms and are donned to maintain asepsis in the operating room.
Use of double gloves is recommended especially on operations in contact with blood and secretions contaminated with hepatitis, AIDS, and the likes.
An operating room has special equipment such as respiratory and cardiac support, emergency resuscitative devices, patient monitors, and diagnostic tools.
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