Unsuspected glove perforation during ophthalmic surgery
K. M. Miller and L. Apt
Jules Stein Eye Institute, Los Angeles, Calif. 90024-7002.
OBJECTIVES--To determine the rate of perforation of surgical gloves after
ophthalmic surgery and to identify factors that contribute to the
development of perforations. DESIGN--Case-control study of used and unused
surgical gloves collected during a 7-month period. SETTING--The
ophthalmology surgical suites of a major teaching hospital. MAIN OUTCOME
MEASURES--Development of glove perforations as measured by five different
techniques. RESULTS--We tested 103 pairs of latex surgical gloves before
use and 454 pairs of gloves after use. Of five techniques used to test for
pinholes, air inflation with water submersion and compression was found to
be the most sensitive, yielding a 6.80% prevalence in control glove pairs
and a 21.81% prevalence in study glove pairs (P = .0005). When examined by
subspecialty area, the lowest perforation rate (11.39%; P = .00009)
occurred in cataract and intraocular lens surgery and the highest rate
(41.67%; P = .003) occurred in oculoplastic surgery. Factors that
correlated significantly with the development of perforations as determined
by multiple logistic regression analysis included pediatric ophthalmology
and strabismus surgeries, oculoplastic surgeries, level of training of the
surgeon, duration of operation, and larger glove size. The thumb and index
fingers of the nondominant hand contained the largest numbers of pinholes.
CONCLUSIONS--The rate of surgical glove perforation after ophthalmic
surgery is relatively high. Recommendations for reducing the rate of glove
perforation are discussed.
