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Surgical site infection rate similar with sterile, nonsterile glove use in outpatient surgery

There were no major differences in the rates of postoperative surgical site infection in outpatient cutaneous surgical procedures performed with sterile gloves vs. nonsterile gloves, according to study results recently published in JAMA Dermatology.

Jerry D. Brewer, MD, of the division of dermatologic surgery, Mayo Clinic, Rochester, Minnesota, and colleagues conducted a search of Ovid Medline (1946-present), Ovid Cochrane Central Register of Controlled Trials (1991-present), Ovid Embase (1988-present), EBSCO Cumulative Index to Nursing and Allied Health Literature (1980-prsent), Scopus (1996-present) and the Web of Science (1975-present) for studies to include in a systematic review and meta-analysis. The studies included patients who underwent outpatient cutaneous or mucosal surgical procedures, including Mohs micrographic surgery (MMS), laceration repair, standard excisions or tooth extractions, and had information on the use of sterile or nonsterile gloves and the presence postoperative surgical site infection (SSI).

Jerry D. Brewer

Randomized clinical trials and comparative studies were included in the analysis, with postoperative wound SSI used as primary outcome variable. In a secondary meta-analysis, there was a separate analysis of all studies pertaining only to cutaneous surgery and all studies pertaining only to dental procedures. Studies pertaining only to MMS were used in a subgroup meta-analysis.

There were 14 articles included in the systematic review including 12,275 patients who underwent 12,275 unique outpatient procedures with sterile and nonsterile gloves and had follow-up data on SSI.

With the exclusion of one study in which patients underwent MMS with nonsterile gloves, there were 11,071 patients included in the meta-analysis. Of those patients, 228 (2.1%) were documented as having postoperative SSI, including 107 (2.1%) in the nonsterile glove cohort and 121 (2%) in the sterile glove cohort.

There was an overall relative risk for SSI of 1.06 (95% CI, 0.81-1.39) for the nonsterile glove cohort in the combined analysis of all the studies, including the MMS study of nonsterile gloves only. None of the relative risks in the analyses of the studies were significant.

“The systematic review and meta-analysis found no difference in the rates of postoperative SSI in outpatient surgical procedures performed with nonsterile vs. sterile gloves,” the researchers concluded. “Given the cost difference between these gloves and the multitude of outpatient surgical procedures performed worldwide, these findings could have a significant effect on and implications for current practice standards.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.