Mechanisms of glove tears and sharp injuries among surgical personnel
J. G. Wright, A. J. McGeer, D. Chyatte and D. F. Ransohoff
Department of Surgery, Yale University School of Medicine, New Haven, Conn.
OBJECTIVE.--The development of strategies to prevent exposure to blood for
operating room personnel has been hampered by a lack of knowledge about the
specific mechanisms of exposure. The purpose of this study was to classify
the mechanisms of glove tears and sharp injuries in the operating room.
DESIGN.--During a 3-month period, a nurse interviewed operating room
personnel immediately after a glove tear or sharp injury had occurred.
SETTING.--Yale-New Haven (Conn) Hospital is a tertiary care teaching
hospital. RESULTS.--There were 249 glove tears and 70 sharp injuries.
Visible skin contact with the patient's blood occurred in 156 glove tears
(63%). The mechanism causing the tear could be identified in only 81 (33%).
For 230 glove tears (92%), personnel were wearing single gloves. Of 70
sharp injuries, 47 (67%) were caused by needles and usually occurred during
suturing. The following three mechanisms accounted for 40 sharp injuries
(57%): (1) hands injured while stationary and holding an instrument, 11
(16%)-a position of risk not previously identified; (2) hands injured while
retracting tissue, 12 (17%); and (3) injuries caused by sharp instruments
not being used, 17 (24%). Instrument passage caused only four sharp
injuries (6%). CONCLUSIONS.--The majority of glove tears have an unknown
mechanism, and alteration in the manufacture or number of gloves worn may
be helpful in reducing cutaneous blood exposures. The identification of
specific mechanisms of sharp injuries should lead to effective strategies
to prevent exposure to the human immunodeficiency virus and other
blood-borne pathogens in the operating room.
