Infection prevention in breast implant surgery – A review of the surgical evidence, guidelines and a checklist

Barr SP, Topps AR, Barnes NL, Henderson J, Hignett S, Teasdale RL, McKenna A, Harvey JR, Kirwan CC; Northwest Breast Surgical Research Collaborative

"We have produced a perioperative "Theatre Implant Checklist" for SSI prevention in implant-based breast surgery, with a set of pragmatic up to date guidelines, which allows the reader to evaluate the evidence upon which our recommendations are based."

Glove and gown effects on intraoperative bacterial contamination

Ward WG Sr, Cooper JM, Lippert D, Kablawi RO, Neiberg RH, Sherertz RJ

"Paper gowns demonstrated less bacterial transmission in the laboratory and lower rates of contamination in the operating room. Disposable paper gowns are recommended for all surgical cases, especially those involving implants, because of the heightened risk of infection. Outer glove exchange just before handling implant materials is also recommended to minimize intraoperative contamination."

Prevention and control of surgical site infections: review of the Basel Cohort Study

Junker T, Mujagic E, Hoffmann H, Rosenthal R, Misteli H, Zwahlen M, Oertli D, Tschudin-Sutter S, Widmer AF, Marti WR, Weber WP

A prospective observational cohort study including 6,283 consecutive general surgery procedures was performed to evaluate risk factors and to validate current preventive measures for surgical site infection. The Basel SSI Cohort Study suggested that surgical antimicrobial prophylaxis (SAP) should be administered between 74 and 30 minutes before surgery. Routine change of gloves or double gloving is recommended in the absence of SAP.

The comparison of double gloving to single gloving in the theatre environment

Phillips S

A literature review of the available evidence comparing double gloving to single gloving sought to provide recommendations for practice. One recommendation included mandatory double glove wear in all major surgical procedures, especially in cases involving heavier contamination, of long duration and of high exposure to sharps.

Concentration of bacteria passing through puncture holes in surgical gloves

Harnoß J-C, Partecke L-I, Heidecke C-D, Hübner N-O, Kramer A, Assadian O

A study of double-layered surgical gloves worn during 20 septic laparotomies measured the passing of bacteria through glove punctures among 128 outer gloves and 122 inner gloves. It suggested preventing punctures by strengthening glove areas that may be prone to puncturing and changing gloves every 90 minutes.

Surgical Glove Perforation and the Risk of Surgical Site Infection

Misteli H, Weber WP, Reck S, Rosenthal R, Zwahlen M, Fueglistaler P, Bolli MK, Oertli D, Widmer AF, Marti WR

A prospective observational cohort study analyzed 4,147 general surgical procedures. Results indicated that glove perforation increased the risk of surgical site infection in procedures without surgical antimicrobial prophylaxis.

Double or Single Gloves: Which Is Safer in Pediatric Orthopedic Surgery

Al-Habdan I, Corea JR, Sadat-Ali M

A study including 842 gloves used during 150 pediatric orthopedic operations determined the use of double gloves are safer than single gloves during pediatric orthopedic surgical procedures. There is a relationship between surgical site infection and glove perforations.

Double gloving to reduce surgical cross-infection

Tanner J, Parkinson H

A review of randomised controlled trials involving additional glove protection determined that a second pair of surgical gloves significantly reduces perforations to the innermost gloves.