Abstract. Oral and maxillofacial surgery, which involves several sharp instruments and fixation materials, is consistently at a high risk for cross-contamination due to perforated gloves, but it is unclear how often such perforations occur. This study aimed to address this issue. The frequency of the perforation of surgical gloves (n = 1436) in 150 oral and maxillofacial surgeries including orthognathic surgery (n = 45) was assessed by the hydroinsufflation technique. Orthognathic surgery had the highest perforation rate in at least 1 glove in 1 operation (91.1%), followed by cleft lip and palate surgery (55.0%), excision of oral soft tumour (54.5%) and dental implantation (50.0%). The perforation rate in scrub nurses was 63.4%, followed by 44.4% in surgeons and first assistants, and 16.3% in second assistants. The odds ratio for the perforation rate in orthognathic surgery versus other surgeries was 16.0 (95% confidence interval: 5.3–48.0). The protection rate offered by double gloving in orthognathic surgery was 95.2%. These results suggest that, regardless of the surgical duration and blood loss in all fields of surgery, orthognathic surgery must be categorized in the highest risk group for glove perforation, following gynaecological and open lung surgery, due to the involvement of sharp objects.
SUMMARY. The treatment of some maxillofacial fractures has an incidence of glove perforation as high as 50%,with over 80% going unnoticed at the time of operation. We investigated double gloving and a glove perforationindication system to ascertain whether the latter offered any additional protection.1061 gloves used for 113 patients were examined. The outer glove perforation rate was significantly higher thanthe inner glove (0.48 compared with 0.10, P<0.0001). There were fewer unnoticed perforations in the gloveperforation indication group than the standard surgical glove group (19% compared with 79%, P<0.0001). Theindication system was most effective in wet operating fields.The perforation rate varied with the type of fracture and treatment. Mandibular fractures that were ‘hand-held’,while bone-plated had a lower mean number of outer glove perforations/operation than fractures treated withtemporary intermaxillary fixation (0.43 compared with 4.62, P<0.0001).
Innate danger of oral and maxillofacial surgery• Oral and maxillofacial surgery requires various sharp instrument• Surgeon should treat Broken bones which often has sharp edges during reduction for proper fixation.
There was no significant difference between single and double glove group in comfort and sensitivity
Discussion• Double glove method – Reduce the risk of exposure to body fluids and cross infection – Does not decrease comfort and sensitivity of clinician.• Reveal method – Helps to detect perforation nearly four folds in relatively wet surgical environment. – required when IMF is recommended.