In an article entitled "Surgical Glove Perforation" Br. J. Surg. 1988, Vol 75, October, 966-968, it was stated "the surgical glove was introduced in 1889 by Halsted to protect his nurse assistant, Caroline Hampton, from dermatitis caused by mercuric chloride used for Listerian antisepsis. It was soon realized that sterile gloves provided a barrier between the surgeons, hands and the patient and could thus reduce iatrogenic infection. Lord Moynahan pioneered their use in the UK and the wearing of gloves during surgery has long been standard practice.
Modern surgical scrub technique dramatically reduces the bacterial counts on surgeons remain. It has often been stated that when glove perforation occurs, bacteria can escape and contaminate the wound, thus leading to an increased risk of wound sepsis. For this reason surgeons change their gloves during an operation when perforation has occurred although supporting bacteriological evidence is "scant". While the technology of surgical gloves has made tremendous advances in terms of quality of the touch retained by the user as well as a high residual manipulative capability of the hand and fingers including wearer comfort, the current American (voluntary) Standard ASTM D3577-78 permits new gloves to have 1/2% holes. Even more hazardous, at the end of operations 10-50% of surgeon's gloves are reported to have holes (Church, J., Sanderson, P.: Surgical Glove Punctures. Journ. Hosp. Infect. Control 1980, 1:84).
In the Br. J. Surg. publication identified hereinabove, the authors also reported on a study to investigate the incidence and significance of surgical glove perforation, bacterial contamination of surgeons' hands and gloves before and after operation was measured and the gloves tested for damage. Perforations were found in 74 of 582 gloves (12.7 per cent) and occurred in 34.5 per cent of operations. Glove perforation did not influence bacterial counts on the surgeons' hands or on the outside of their gloves. A separate clinical study of 100 adult hernia repairs gave no evidence that perforation increased wound sepsis. After standard clinical significance to the patient, but their high incidence should alert surgeons to the need for protection against pathogens transmissible during surgery, such as hepatitis B and the human immunodeficiency virus. Protection of the surgeon is an indication for preoperative change of damaged gloves throughout the course of the operation or surgical procedure. Increased incidence of risk for the persons performing activities with respect to persons having dreaded communicable diseases which are transmitted via the bodily fluids, make protection of the user of sharp instruments such as surgical knives and/or needles a major concern and has emphasized the need for the proper use of surgical gloves. Proper use is also particularly important for the person using the surgical instrument or conducting any activity inside the body of the infected or potentially infected patient and particularly when the surgical or protective gloves are penetrated and at the same time the user of the gloves is provided with little protection from such sharp objects as a needle, knife or scissor's edge, etc. While no evidence has yet established that a surgeon can contract the AIDS virus by penetrating his surgical glove and his own skin with a needle or similarly penetrating instrument, there is an overwhelming concern about the possibility which is to significant to ignore. The teachings of the present invention respond to this concern.
The problem with holes in surgical gloves has been studied by others in addition to the report sited hereinabove, one such report is by H. Matta, et al, entitled "Does wearing two pairs of gloves protect operating theatre staff from skin contamination?", pages 597-598--BMJ volume 290--Sept. 3, 1988. Therein, ten surgeons and nine scrub nurses in a surgical unit wore two pairs of gloves during general surgical operations on 144 consecutive patients. The gloves were tested at the end of the operation by a recognized method detecting perforation. The following table was reported: Numbers of punctures detected at different sites in 728 outer and inner gloves
______________________________________ Left hand Right hand Outer glove Inner glove Outer glove Inner glove ______________________________________ Thumb 6 1 Index 33 5 finger Third 6 1 4 1 finger Fourth 3 2 1 finger Fifth 1 finger Palm 16 6 5 1 ______________________________________
It is notable that three quarters of the perforations have occurred on the index finger of the left hand. It may therefore be presumed, particularly if both gloves frequently contained holes, that these were punctured holes produced by sharp instruments rather than tears or other violence; or, part of the permitted quality level original holes in the glove.
While this reported study confirms that wearing two pairs of surgical gloves confers some protection against contamination of the surgeons or nurses from the patients tissue and fluids, a very significant aspect of the results is that it identifies to a substantial degree where the glove punctures are located. For example, the non-dominant hand for the user of surgical instruments would be the left hand and therein is were the largest number of punctures are identified. That fact and the location of the punctures in the categories as set forth in the table leads to the conclusion that while all of the punctures or holes in the gloves are not the result of self inflicted punctures by the user through the use of the surgical instrument, many are. The locations of those punctures are identified and give the user an idea of where they may be causing punctures of the surgical gloves as well as the invasion of their own skin. The information described above is confirmed by an article entitled "Risk to Surgeons: A Survey of Accidental Injuries During Operations", Br. Journal of Surg. April 1988, pp:314-315.