Electronic evaluation of the value of double gloving

Background: Breakdown of the surgeon-patient barrier represents a risk for transmission of infectious disease. Such breakdowns are frequently not reco gnized by the surgical team. The protection afforded by double gloving unde r normal operating conditions was evaluated. Methods: An electronic device detected breakdown of the surgeon-patient bar rier in a series of 80 surgical procedures, randomly assigned to either dou ble or single gloving. Fluid contact due to glove perforation, porosity or gown wetting was recorded during 151 individual surgeon episodes covering 2 38 operator-hours. Surgical procedures were called superficial for incision s of less than 10 cm. Results: Double gloving reduced the number of perforation and porosity alar ms twofold in both superficial and deep surgical procedures. Deep procedure s carried a sevenfold increased risk of barrier breakdown compared with sup erficial procedures, the risk being greatest for the principal operator. Conclusion: Without electronic detection, a large majority of barrier break downs would remain undetected by the surgical team and lead to prolonged co ntact with potentially contaminating body fluids. The use of double gloving provides real protection against such contamination risks.