Decreasing Bacterial Contamination from Surgical Gloves, Gowns

William G Ward, Sr. MD Chair of Orthopaedic Surgery, Chief of Musculoskeletal Service Line - Guthrie Clinic One Guthrie Square Sayre, Pennsylvania 18840 (Professor Emeritus - Wake Forest University Dept of Orthopaedic Surgery) MedicalResearch.com Interview with:
William G Ward, Sr. MD
Chair of Orthopaedic Surgery, Chief of Musculoskeletal Service Line – Guthrie Clinic
Sayre, Pennsylvania 18840
(Professor Emeritus – Wake Forest University Dept of Orthopaedic Surgery)

MedicalResearch.com: What are the main findings of this study?

Dr. Ward: The main findings of the study include:

  1. The use of disposable spun-lace “paper” gowns was associated with a dramatic decrease in the likelihood of culture-detected bacterial contamination on the surgeon’s gloved hand and gown sleeve.
  2. For a double-gloved surgeon, changing the outer glove just prior to implant handling should decrease bacterial contamination from the surgeon by about 50%.
  3. Bacteria suspended in saline solution transgressed the material of standard reusable scrub attire in 96% (26/27) of tested gowns and in 0% (0/27) of spun-lace disposable “paper” gowns.

MedicalResearch.com: Were any of the findings surprising?

Dr. Ward: When we performed the first outer glove exchange study, we had simply recorded the gown type. The overpowering significant effect of gown type had not been anticipated.

MedicalResearch.com: What should patients and clinicians take away from this report?

Dr. Ward: Take Away Message:

Reusable cloth gowns do not provide an adequate barrier to bacterial transgression from the surgeon’s skin and should be abandoned and replaced with verifiable occlusive gowns such as spun-lace paper gowns. A similar recommendation regarding reusable cloth versus disposable “paper” drapes or other occlusive disposable drapes is also recommended, however this was not specifically tested in this project.

MedicalResearch.com: What future research do you recommend as a result of this study?

Dr. Ward: We have already performed additional research regarding glove donning technique, confirming that a technique whereby the surgeon is assisted in gloving and during which he keeps his fingertips withdrawn inside the gown sleeve until the sleeve is engaged within the cuff is associated with an almost seven-fold decrease in bacterial contamination, compared to gloving when the fingers extend beyond the cuff upon entering the opened glove, and over a seven-fold decrease in contamination compared to self-gloving. Additional studies of various drape materials are indicated, as well studies of various gloving techniques to decrease the contamination that inevitably occurs with current self-gloving techniques.

Citation:

Glove and Gown Effects on Intraoperative Bacterial
Contamination
Ward WG Sr1, Cooper JM, Lippert D, Kablawi RO, Neiberg RH, Sherertz RJ.
Ann Surg. 2014 Mar;259(3):591-7. doi: 10.1097/SLA.0b013e3182a6f2d9.