At what point during total knee arthroplasty operations are gloves most frequently torn?

Abstract

The aim of this study was to determine the time points during a total knee arthroplasty operation when there is the greatest possibility of tearing a surgical glove and thus the stage of the operation at which there is the greatest risk of infection. The study included 300 total knee arthroplasty cases performed by 10 orthopedic surgeons. Using a chronometer during the operation, the upper layer of each surgical glove was removed and inflated with sterile saline at 10-min intervals. When a tear was determined, a record was made of the time it occurred, the stage of the operation, the finger that was torn, and the side (right or left hand). The mean time of the glove perforation was 40.74 ± 10.69 min. Glove tears occurred at the rate of 28.9% (<i>n</i> = 39) in the thumb, 63.7% (<i>n</i> = 86) in the index finger, 2.2% (<i>n</i> = 3) in the middle finger, and 5.2% (<i>n</i> = 7) in the ring finger. The tears occurred after the femoral cut in 8.1% (<i>n</i> = 11), after the tibial cut in 14.8% (<i>n</i> = 20), at the stage of trial component reduction in 52.6% of cases (<i>n</i> = 71), after placement of the prosthesis in 7.4% (<i>n</i> = 10), and at the closure stage in 17% (<i>n</i> = 23) (<i>p</i> < 0.001). The fingers requiring the most care during total knee arthroplasty are the thumb and index finger. The stages of the operation with the greatest risk for glove tears are trial component reduction and wound closure. Changing gloves after these high-risk surgical stages would help to decrease the risk of periprosthetic infections. Level IV/Case series.