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Evidence summaries

Double Gloving to Reduce Surgical Cross-Infection

The addition of a second pair of surgical gloves, as well as triple gloving, knitted outer gloves and glove liners significantly reduce perforations to the innermost gloves. There is no direct evidence that additional glove protection reduces surgical site infections in patients. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 2 studies addressing the primary outcome, surgical site infections in patients. Both trials reported no infections. Additionally, 31 randomised controlled trials measuring glove perforations were identified and included in the review. Fourteen trials of double gloving (wearing two pairs of surgical latex gloves) were pooled and showed that there were significantly more perforations to the single glove than the innermost of the double gloves (OR 4.10, 95% CI 3.30 to 5.09). Eight trials of indicator gloves (coloured latex gloves worn underneath latex gloves to more rapidly alert the team to perforations) showed that significantly fewer perforations were detected with single gloves compared with indicator gloves (OR 0.10, 95% CI 0.06 to 0.16) or with standard double glove compared with indicator gloves (OR 0.08, 95% CI 0.04 to 0.17). Two trials of glove liners (a glove knitted with cloth or polymers worn between two pairs of latex gloves)(OR 26.36, 95% CI 7.91 to 87.82), three trials of knitted gloves (knitted glove worn on top of latex surgical gloves)(OR 5.76, 95% CI 3.25 to 10.20) and one trial of triple gloving (three pairs of latex surgical gloves)(OR 69.41, 95% CI 3.89 to 1239.18) all compared with standard double gloves, showed there were significantly more perforations to the innermost glove of a standard double glove in all comparisons.

    References

    • Tanner J, Parkinson H. Double gloving to reduce surgical cross-infection. Cochrane Database Syst Rev 2006;3:CD003087 [Last assessed as up-to-date: 28 July 2009]. [PubMed]

Primary/Secondary Keywords