Surgical glove perforation and the risk of surgical site infection

Misteli, Heidi; Weber, Walter P; Reck, Stefan; Rosenthal, Rachel; Zwahlen, Marcel; Fueglistaler, Philipp; Bolli, Martin K; Oertli, Daniel; Widmer, Andreas F; Marti, Walter R (2009). Surgical glove perforation and the risk of surgical site infection. Archives of surgery, 144(6), pp. 553-558. Chicago, Ill.: American Medical Association

Misteli ArchSurg 2009.pdf - Published Version
Available under License Publisher holds Copyright.

Download (123kB) | Preview

HYPOTHESIS: Clinically apparent surgical glove perforation increases the risk of surgical site infection (SSI). DESIGN: Prospective observational cohort study. SETTING: University Hospital Basel, with an average of 28,000 surgical interventions per year. PARTICIPANTS: Consecutive series of 4147 surgical procedures performed in the Visceral Surgery, Vascular Surgery, and Traumatology divisions of the Department of General Surgery. MAIN OUTCOME MEASURES: The outcome of interest was SSI occurrence as assessed pursuant to the Centers of Disease Control and Prevention standards. The primary predictor variable was compromised asepsis due to glove perforation. RESULTS: The overall SSI rate was 4.5% (188 of 4147 procedures). Univariate logistic regression analysis showed a higher likelihood of SSI in procedures in which gloves were perforated compared with interventions with maintained asepsis (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.4-2.8; P < .001). However, multivariate logistic regression analyses showed that the increase in SSI risk with perforated gloves was different for procedures with vs those without surgical antimicrobial prophylaxis (test for effect modification, P = .005). Without antimicrobial prophylaxis, glove perforation entailed significantly higher odds of SSI compared with the reference group with no breach of asepsis (adjusted OR, 4.2; 95% CI, 1.7-10.8; P = .003). On the contrary, when surgical antimicrobial prophylaxis was applied, the likelihood of SSI was not significantly higher for operations in which gloves were punctured (adjusted OR, 1.3; 95% CI, 0.9-1.9; P = .26). CONCLUSION: Without surgical antimicrobial prophylaxis, glove perforation increases the risk of SSI.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Zwahlen, Marcel




American Medical Association




Factscience Import

Date Deposited:

04 Oct 2013 15:10

Last Modified:

30 Jun 2015 13:26

Web of Science ID:




URI: (FactScience: 194910)

Actions (login required)

Edit item Edit item
Provide Feedback