The effects of two surgical gowning and gloving methods on the extent of contamination of surgical team members' gowns and gloves: A single-blind controlled trial

Document Type : Original Article

Authors

1 Department of Operating Room, Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Operating Room, Nursing and midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: The method used to wear the surgical gown and gloves has a critical role in the extent of surgical site contamination.
Objectives: The purpose of this study was to compare the effect of gown and gloves wearing in the integrated and closed methods on the extent of contamination of surgical team members' gowns and gloves. 
Methods: A single-blind controlled trial was conducted with 70 eligible surgical staff who were randomly assigned to two groups of 35. The intervention group wore sterile, integrated gown-glove units, whereas the control group wore separate gowns and gloves using the closed technique. Glitterbug fluorescent powder was used to measure contamination. An ultraviolet flashlight was used to make the Glitterbug powder visible. Participants in both groups wore their gowns and gloves after dipping their hands in fluorescent powder. After one hour of the surgery, the gowns and gloves were removed from the body, a mobile phone was used to take photos of the areas containing powder, and ImageJ software was used to measure the area of contamination. The independent samples t-tests and chi-square test were used to analyze the data.
Results: The contaminated area of gloves was 0.06±0.24 mm2 for the integrated gown-glove unit method and 2.26± 5.87 mm2 for the closed gown and gloves wearing method (P= 0.03). The contaminated area of the gown was zero for the integrated method and 3.06±7.57 mm2 for the closed method (P= 0.02).
Conclusion: The extent of contamination was less when using the integrated gown-glove unit than the closed method. The surgical staff are recommended to use integrated gown-glove units to reduce the risk of contamination of gowns and gloves used for surgery.

Highlights

Ahmad Ghadami [Pubmed] [Google Scholar]

Keywords


  1. Remschmidt B, Schwaiger M, Gaessler J, Wallner J, Zemann W. Surgical site infections in orthognathic surgery: prolonged versus single-dose antibiotic prophylaxis. Int J Oral Maxillofac Surg 2023;52:219-226. doi:10.1016/j.ijom.2022.06.002 PMid:35760661
  2. Shiferaw WS, Aynalem YA, Akalu TY, Petrucka PM. Surgical site infection and its associated factors in Ethiopia: a systematic review and meta-analysis. BMC surg 2020;20:107. doi:10.1186/s12893-020-00764-1 PMid:32423397 PMCid:PMC7236319
  3. Nauman SM, Haroon Y, Ahmad A, Saleem I. Surgical site infection; prophylactic antibiotics in laparoscopic cholecystectomy to reduce surgical site infection. Professional Med J 2018;25:1-4. doi:10.29309/TPMJ/18.4133
  4. Global Guidelines for the Prevention of Surgical Site Infection. Geneva: World Health Organization; 2018. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536404/ [Last access date 2.3.2021].
  5. Handaya AY, Werdana VAP. Adherence to preoperative hand hygiene and sterile gowning technique among consultant surgeons, surgical residents, and nurses: a pilot study at an academic medical center in Indonesia. Patient Saf Surg 2019;13:11. doi:10.1186/s13037-019-0193-5 PMid:30899331 PMCid:PMC6410512
  6. Sundet A, Nelms NJ, Michelson JD. Donning Gloves Before Surgical Gown Cross-contaminates the Assistant. Arthroplast Today. 2022;17:142-144. doi:10.1016/j.artd.2022.08.009 PMid:36158460 PMCid:PMC9493291
  7. Byrd WA, Kavolus JJ, Penrose CT, Wellman SS. Donning Gloves Before Surgical Gown Eliminates Sleeve Contamination. J Arthroplasty 2019;34:1184-1188. doi:10.1016/j.arth.2019.01.015 PMid:30878507
  8. Hosseini M, Ghadami A, Hashemi S. A study of the effects of three gloves donning techniques on the contamination. J Clin Anal Med 2017;8:458-63.
  9. Sellens P, Wellbelove Z, Wright D. Testing contamination and cleaning effectiveness in theatre during the COVID-19 pandemic using UV fluorescent powder. Anaesthesia 2021;76:136-137. doi:10.1111/anae.15200 PMid:32643170 PMCid:PMC7361571
  10. Kang J, Kim EJ, Choi JH, Hong HK, Han SH, Choi IS, et al. Minimizing contamination in the use of personal protective equipment: simulation results through tracking contamination and enhanced protocols. Am J Infec Control 2021;49:713-720. doi:10.1016/j.ajic.2020.11.002 PMid:33159995 PMCid:PMC7832077
  11. WMA Declaration of Helsinki-ethical principles for medical research involving human subjects. July 9, 2018. Available from: https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/. [Last access date 21.5.2021].
  12. Fraser JF, Young SW, Valentine KA, Probst NE, Spangehl MJ. The Gown-glove Interface Is a Source of Contamination: A Comparative Study. Clin Orthop Relat Res 2015;473:2291-7. doi:10.1007/s11999-014-4094-8 PMid:25488405 PMCid:PMC4457760
  13. Jalali H, Naji SA. Comparison of the level of contamination of gloves and surgical gloves after wearing gloves in two closed methods by the individual and wearing gloves with the help of a scrub in the operating room of Ayatollah Kashani Training Center in Isfahan in 2018. National Conference on Promotion Individual, family and community health 2019. Available from: https://civilica.com/doc/977681/ [Last access date 21.5.2021]
  14. Seidelman J, Anderson DJ. Surgical Site Infections. Infect Dis Clin North Am 2021;35:901-929. doi:10.1016/j.idc.2021.07.006 PMid:34752225