REDUCTION IN INCIDENCE OF GLOVE PERFORATION DURING LAPAROTOMY WOUND CLOSURE BY NO TOUCH TECHNIQUE

Intact surgical gloves provide an efficient barrier against the HIV an d Hepatitis B viruses but glove perforations are common, particularly during mass closure of laparotomy wounds. Attempts to develop gloves i mmune to perforation have failed. A series of 100 consecutive laparoto my wounds were randomised to mass closure by either the 'hand in' tech nique currently favoured by many surgeons, or a 'no touch' technique m anipulating the wound edges with instruments only. The two groups were similar with regard to grade of surgeon and assistant, proportion of routine and emergency cases, and proportion of clean or dirty cases. T he wound lengths in each group were similar, and the time taken to clo se the abdominal wall was similar in both groups. Although a similar n umber of perforated gloves occurred in each group while the operative procedure was being performed ('hand in', 9 of 50 vs 'no touch', 12 of 50; P = 0.62); a significantly reduced number of glove perforations o ccurred in the 'no touch' group during wound closure ('hand in', 16 of 50 vs 'no touch', 3 of 50, P = 0.0017). No touch closure of the abdom inal wall may provide protection to surgeons against blood-borne virus es such as HIV and hepatitis B.