SURGICAL GLOVE PUNCTURES DURING CARDIAC OPERATIONS

A new method of detecting occult glove punctures was devised to determ ine its frequency during cardiac operations. Glove puncture is of rele vance to the transmission of infectious diseases and the potential con tamination of implanted cardiac prostheses. A study was therefore carr ied out in 48 adult patients undergoing open heart operations in which gloves worn by surgeons and nurses were collected and evaluated at th e end of each procedure. In 22 of these cases, gloves were changed at three different stages of the cardiac operation for the principal oper ators: stage I, skin incision to commencement of cardiopulmonary bypas s; stage II, cardiopulmonary bypass to sternotomy closure; and stage I II, sternotomy closure to skin closure. One hundred sixty-two gloves ( 31.5%) had one or more punctures out of a total of 514 gloves tested. Only 20 glove punctures were recognized either at the time or at the e nd of the operation. There were 185 occult glove punctures. The majori ty (60%) of punctures were on the nondominant hand, with 30% of perfor ations located in the nondominant index finger. Using the chi2 test wi th two degrees of freedom, there is no significant difference between the glove perforation rates for the principal operators in stages I, I I, and III. The most important finding from this study was that 61% of gloves worn by scrub nurses had one or more punctures compared with 2 3.6% of surgeons.