The level of evidence is downgraded by indirectness of evidence (only surrogate outcomes reported)
The use of double gloves is recommended in procedures with high risk of exposure injuries to prevent health care workers becoming infected with a viral disease such as hepatitis or HIV.
A Cochrane review [Abstract] 1 included 34 studies with a total of 6890 person-operations as participating units in 46 intervention-control group comparisons. Interventions were grouped as follows: increased layers of standard gloves, gloves manufactured with special protective materials or thicker gloves, and gloves with puncture indicator systems. Indicator gloves show a coloured spot when they are perforated. Participants were surgeons in all studies and they used at least one pair of standard gloves as the control intervention. Twenty-seven studies also included other surgical staff (e.g. nurses). All but one study used perforations in gloves as an indication of exposure.
The median control group rate was 18.5 perforations per 100 person-operations. Seven studies reported blood stains on the skin and two studies reported self reported needlestick injuries. Six studies reported dexterity as visual analogue scale scores for the comparison double versus single gloves, 13 studies reported outer glove perforations.
Double gloves compared to single gloves reduce the risk of glove perforation (RR 0.29, 95% CI 0.23 to 0.37) and the risk of blood stains on the skin (RR 0.35, 95% CI 0.17 to 0.70). Two studies also reported the effect of double compared to single gloves on needlestick injuries (RR 0.58, 95% CI 0.21 to 1.62).In one small study the use of three gloves compared to two gloves reduces the risk of perforation further (RR 0.03, 95% CI 0.00 to 0.52). There was similar levidence that the use of one fabric glove over one normal glove reduces perforations compared to two normal gloves (RR 0.24, 95% CI 0.06 to 0.93). This effect was similar for the use of one special material glove between two normal material gloves. Thicker gloves did not perform better than thinner gloves.In two studies an indicator system did not reduce the total number of perforations during an operation even though it reduces the number of perforations per glove used.Double gloves had a similar number of outer glove perforations as single gloves, indicating that there was no loss of dexterity with double gloves (RR 1.10, 95% CI 0.93 to 1.31).
User acceptance of double gloves should be evaluated more precisely in different procedures.
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