Influence of intraoperative closed glove exchange on glove contamination during clean soft tissue surgeries.

OBJECTIVES:To determine the influence of intraoperative glove exchange on glove contamination during clean soft tissue surgery. STUDY DESIGN:Prospective clinical study. SAMPLE POPULATION:Two hundred pairs of gloves and gowns from 50 clean soft tissue surgeries. METHODS:Gloves and gown cuffs were cultured from the primary surgeon and first assistant using a standardized protocol. Cultures were taken from outer surface of both gown cuffs prior to surgery and after gloves were removed at the end of surgery; gloves were cultured prior to surgery, at end of surgery and after a new pair was donned after closed glove exchange. Cultures were evaluated for colony-forming units after 72 h of inoculation. RESULTS:Bacterial contamination was documented in 41 of the 50 surgeries (82%). The most common species cultured was Streptocococcus spp. There was no difference (p = .719) in the bacterial contamination rate of gown cuffs prior to surgery (10%; 20/200) compared to after surgery (9.5%; 19/200). The bacterial contamination rate for gloves was 10.5% (21/200) prior to surgery, 19.5% (39/196) after surgery, and 11% (22/200) after regloving. Gloves cultured following surgery were significantly more contaminated than gloves cultured preoperatively (p = .010) or gloves cultured following regloving (p = .018). CONCLUSION:Glove exchange did not increase bacterial contamination of gloves during the clean soft tissue surgeries tested here. CLINICAL SIGNIFICANCE:The outside of the gown cuff does not seem to represent a major source of contamination during clean procedures. This study does not provide evidence to support a change in current practices for intraoperative closed glove exchange.