Surgical antisepsis practices and use of surgical gloves as a potential risk factors to intraoperative contamination

Oliveira, Adriana Cristina de; Gama, Camila Sarmento

doi:10.5935/1414-8145.20160051

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RESEARCH • Esc. Anna Nery 20 (2) • Apr-Jun 2016 • https://doi.org/10.5935/1414-8145.20160051 copy

Surgical antisepsis practices and use of surgical gloves as a potential risk factors to intraoperative contamination

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

This study aimed to investigate the practice of surgical hand antisepsis and integrity of sterile gloves after use by the surgical team in a teaching hospital in the city of Belo Horizonte, Southeastern Brazil.

Methods:

A cross-sectional study was conducted involving the gynecology service in April 2013. Data were collected through observation of surgical hand antisepsis and test to evaluate surgical glove perforation after use. A descriptive statistical analysis was performed.

Results:

Only 16% of surgeons accomplished the technique and time recommended for the practice of surgical hand antisepsis. Regarding gloves, there were 11.1% of perforations, 31.8% of which were noticed.

Conclusions:

The results presented reveal that failures in these procedures occur routinely, being able to interfere with patients and healthcare workers' safety, prompting reflection on the theme in different health institutions.

Keywords:
Hand Disinfection; Gloves, Surgical; Surgery

Variable	N (50)	(%)
Wearing jewelry
Yes	0	0
No	50	100
Using a brush impregnated with antiseptic
Yes	49	98
No	1	2
Rubbing an antiseptic agent on skin from the hands to the elbows
Yes	48	96
No	2	2
Keeping hands above elbow level
Yes	27	54
No	23	46
Repeating the technique on the opposite arm
Yes	50	100
No	0	0
Fully rinsing in running water
Yes	37	74
No	0	0
Partially (an amount of soap remained)	13	26
Rinsing in a single direction from the hands to the elbows
Yes	25	50
No	25	50
Turning off the tap without contamination
Yes	50	100
No	0	0
Shaking arms vigorously to eliminate excess water
Yes	1	2
No	49	98

Antisepsis time^* * In accordance with ANVISA's recommendations, from three to five minutes was considered to be adequate for the first surgery, and from two to three minutes for the subsequent ones.	First surgery	Total
Yes	No
0 to 59 seconds	2	1	3
60 to 119 seconds	12	1	13
120 to 179 seconds	14	2	16
180 to 239 seconds	13	0	13
240 to 299 seconds	5	0	5
Total	46	4	50

Variable	N (22)	%
Length of time of surgery when glove perforation was detected
0 to 29 minutes	1	4.5
30 to 59 minutes	1	4.5
60 to 89 minutes	2	9.1
90 to 119 minutes	9	40.9
120 to 149 minutes	3	13.7
180 to 209 minutes	4	18.2
300 to 329 minutes	2	9.1
Hand where glove perforation occurred
Single glove on left hand	6	27.3
Single glove on right hand	5	22.7
Inner and outer gloves on left hand concomitantly^* * Referring to a pair of gloves that were perforated simultaneously on the same hand of user;	4	18.1
Outer glove on left hand	3	13.7
Inner glove on right hand⁺ + Gloves were perforated at the time they were put on. Another glove was worn over it (double glove wearing).	3	13.7
Outer glove on right hand	1	4.5
Number of perforations per glove
One perforation	19	86.5
Two or more perforations	3	13.5

Universidade Federal do Rio de Janeiro Rua Afonso Cavalcanti, 275, Cidade Nova, 20211-110 - Rio de Janeiro - RJ - Brasil, Tel: +55 21 3398-0952 e 3398-0941 - Rio de Janeiro - RJ - Brazil
E-mail: annaneryrevista@gmail.com

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[1] Corresponding author: Adriana Cristina de Oliveira. E-mail: adrianacoliveira@gmail.com