后果严重的损害:骨科手术乳胶手套穿孔的分析。

European Journal of Microbiology & Immunology Pub Date : 2018-11-26 eCollection Date: 2018-12-23 DOI:10.1556/1886.2018.00028
Andreas Enz, Annett Klinder, Hannah Mittelmeier, Günther Kundt, Wolfram Mittelmeier, Sarah Zaatreh
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引用次数: 7

摘要

简介:为了防止手术部位感染(ssi),使用无菌外科乳胶手套是很常见的。本研究旨在探讨手术中不同机械应力对手套损伤的影响及其对损伤类型的影响。在初次关节置换术、翻修关节置换术(髋关节和膝关节)和关节镜检查(肩关节和膝关节)期间收集手套。材料和方法:手术后从外科医生处收集外科乳胶手术手套,并进行水密性测试(ISO EN 455-1:2000)。结果:305例择期手术共回收手术手套1460只。平均15.9%的手套出现术后病变,其中关节翻修成形术发生率最高,为25%。在原发性和翻修性关节置换术中,优势手的食指最常受影响(62.7%和58.6%);相比之下,关节镜下手套在拇指和中指上的病变最多(各占42.9%)。撕裂和穿孔大小从≤1 mm到>5 mm不等,初次关节置换术和翻修关节置换术损伤较大。结论:手术手套故障率高,且随机械应力的增大而增加。较高的穿孔发生率主要发生在翻修关节置换术中。破坏手套的完整性,特别是在高机械负荷下,可能会导致感染率增加。
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Damages with High Consequences: Analysis of Perforations in Surgical Latex Operation Gloves from Orthopedic Surgeries.

Introduction: To prevent surgical site infections (SSIs) during operation, the use of sterile surgical latex gloves is common. The aim of this study was to examine the damage of the gloves in surgeries with different mechanical stress and the influence on the kind of damages. Gloves were collected during primary arthroplasty, revision arthroplasty (hip and knee), and arthroscopy (shoulder, hip, and knee).

Materials and methods: Surgical latex operation gloves were collected from surgeons after the operation and were tested with watertightness test (ISO EN 455-1:2000).

Results: A total of 1460 surgical gloves were retrieved from 305 elective operations. On average, 15.9% of the gloves showed postoperative lesions, with the highest incidence occurring in revision arthroplasty with 25%. In primary and revision arthroplasty, the index finger of the dominant hand was most frequently affected (62.7% and 58.6%); in contrast, gloves from arthroscopies had most lesions on thumb and middle finger (42.9% each). Tear and perforation size differed from ≤1 mm to >5 mm, and primary and revision arthroplasty showed bigger damages.

Conclusions: Surgical gloves have a high malfunction, which increases with growing mechanical stress. A high rate of perforation occurred mostly in revision arthroplasty. Breaching the integrity of the gloves, especially by high mechanical loads, could lead to an increased rate of infection.

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