The effect of double gloving on frequency of glove perforations

Article Abstract:

Surgeons wear protective gloves while performing surgery to prevent postoperative wound infections and the transmission of blood-borne diseases, such as HIV infection and hepatitis, from patient to surgeon or from surgeon to patient. The advent of HIV has increased the importance of the efficacy of surgical gloving. This study examined the frequency of glove perforations that occurred during obstetric and gynecologic procedures when the surgeon wore two pairs of gloves (double gloving). Surgeons in the obstetric and gynecology department of a Florida hospital were asked to double glove for all procedures performed between December 1990 and January 1991. The gloves were placed in bags and labeled with the physician's name, the procedure performed, role of the physician in the procedure, and any detectable perforations in the gloves. The gloves were then carefully tested for perforations. Of 441 sets of double gloves collected, holes were present in at least 1 of the 4 gloves in 61 sets (14 percent). Of 67 holes, 52 (78 percent) involved only an outer glove, 9 (13 percent) involved only the inner glove, and 6 (9 percent) involved a matching hole through both inner and outer gloves. The latter number represented 1.4 percent of all glove sets. For obstetric deliveries, gloves were perforated in 15 percent of cesarean deliveries and 11 percent of vaginal deliveries. Perforations occurred in 28 percent of major gynecologic procedures. The procedure with the highest percentage of glove perforations was abdominal hysterectomy (32 percent). By physician type, third- and fourth-year residents were significantly more likely to tear gloves during surgery than were attending physicians and first- and second-year residents. These result demonstrate that double gloving is an effective practice for preventing the transmission of infectious diseases between patients and surgeons. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Prevention, Hospitals, HIV infection, HIV infections, Communicable diseases, Rubber gloves, Gloves (Surgery), Nosocomial infections, Cross infection, Blood-borne diseases, Bloodborne diseases

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Premature rupture of the membranes at term

Article Abstract:

Pregnant women at term who have a premature rupture of the membranes should have labor induced as soon as possible. Research published in 1996 suggesting that expectant management is comparable with the immediate induction of labor in terms of the risk to mother and infant is flawed. Expectant management involves delaying the induction of labor in hopes that labor will occur naturally, while monitoring the pregnant woman for any signs of neonatal or maternal risk. The subjects used in the 1996 study were not well-chosen, and several outcomes that should have been considered when evaluating the differences between immediate induction of labor versus expectant management were not. Induced labor should involve the use of either oxytocin or prostaglandin, both of which have been proven safe and effective. With such effective means for inducing labor, there is no reason to wait, as doing so increases the risk of infection to both mother and child.

Health aspects, Care and treatment, Editorial, Labor, Induced (Obstetrics), Induced labor

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Premature rupture of the fetal membranes

Article Abstract:

Premature rupture of fetal membranes is the tearing of the amniotic sac before the full term of pregnancy and the beginning of labor. This complication may affect nearly 10% of pregnant women, and can increase the risk of infection in the newborn. This rupture may result from the natural stretching caused by a growing pregnancy, or more subtle structural changes. Research suggests changes in collagen production and degradation, nutritional deficiencies, reproductive tract infections, and tobacco smoking may increase the risk of rupture.

Causes of, Physiological aspects, Amniotic sac, Amnion

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