Removing outer surgical gloves may reduce spinal surgery infections

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A study published by the Journal of Spinal Disorders and Techniques may provide a relatively simple method of reducing postoperative spinal surgery infections—a glove change before handling instrumentation.

Lumbar spine fusion with instrumentation is associated with postoperative infection rates of up to 9%, with the Staphylococcus aureus organism (often part of human skin flora) responsible for the majority of infections. This suggests that surgeons’ gloves are the mode of transfer for these organisms from the patients’ skin to the wound.

The authors of this study, led by Amina Rehman, Aga Khan University Hospital, Karachi, Pakistan, conducted a retrospective study to determine if a simple glove change before handling instrumentation could significantly reduce the rate of postoperative infection for this procedure.

A total of 389 patients requiring lumbar spine fusion were enrolled and divided into two groups—a control group of 179 patients treated with standard protocol for the procedure (group A) and a treatment group of 210 patients with whom, after initially “double gloving”, the outer pair of gloves was removed before handling instrumentation. Infection rates were compared up to one year postoperatively.

The authors report that this amended method resulted in a statistically significant reduction of infection rate from 3.35% in group A (control) to 0.48% in group B (p=0.0369).

“This study shows that the removal of an outer pair of gloves before handling instrumentation may be a simple, cost-effective, and practical way to reduce the burden of postoperative infection following lumbar spinal fusion,” conclude Rehman and colleagues.