Double gloving and a system for identifying glove perforations in maxillofacial trauma surgery

The treatment of some maxillofacial fractures has an incidence of glove per foration as high as 50%, with over 80% going unnoticed at the time of opera tion. We investigated double gloving and a glove perforation indication sys tem to ascertain whether the latter offered any additional protection. 1061 gloves used for 113 patients were examined, The outer glove perforatio n rate was significantly higher than the inner glove (0.48 compared with 0. 10, P<0.0001). There were fewer unnoticed perforations in the glove perfora tion indication group than the standard surgical glove group (19% compared with 79%, P<0.0001). The indication system was most effective in wet operat ing fields. The perforation rate varied with the type of fracture and treatment. Mandib ular fractures that were "hand-held', while bone-plated had a lower mean nu mber of outer glove perforations/operation than fractures treated with temp orary intermaxillary fixation (0.43 compared with 4.62, P<0.0001).