Urology Journal

ISSN: 1735-1308

March-April 2023
Vol. 20 No. 02 (2023)

A Multicenter, Prospective, Non-randomized Study Evaluating Surgical hand Preparation between Double-Gloving and Single-Gloving for Preventing Postoperative Infection in Robotic and Laparoscopic Minimally Invasive Surgeries

Urology Journal, Vol. 20 No. 02 (2023), , Page 109-115
https://doi.org/10.22037/uj.v19i.7239

Abstract

Purpose: This study aimed to analyze a feasible and suitable surgical precautionary preparatory technique. The techniques of double-gloving with hygienic hand wash (DH) and single-gloving with surgical hand wash (SS) were compared for their ability to prevent postoperative infection in robotic and laparoscopic minimally invasive surgeries.


Materials and Methods: A prospective, non-randomized, multicenter study was conducted between January 2016 and June 2020. We divided the robotic and laparoscopic cases into two groups: DH and SS. Data on infectious outcomes were collected. Propensity score matching was performed to control for operative characteristics between the two groups. The primary endpoint was the presence of fever and surgical site infections (SSIs) indicating postoperative infection.


Results: Among four medical centers, seven surgeons were allocated to either the DH or the SS group. A total of 221 and 251 patients underwent DH and SS, respectively. Propensity score matching, which included 171 cases from each group, showed that the incidence of fever during hospitalization was significantly lower in the DH group than that in the SS group (11.7% vs. 23.4%, p=0.007). Multivariable analysis revealed that DH was associated with a reduced odds ratio for developing postoperative fever during hospitalization (risk ratio: 0.49, p=0.043). No differences were found in SSI before and after hospitalization between the two groups.


Conclusion: DH resulted in less postoperative fever and had a comparable effect in preventing SSIs. This procedure could be an alternative to the SS protocol in some minimally invasive surgeries.

Keywords:
  • Assistive devices
  • Hand washing
  • Laparoscopy
  • Surgical site infection endoscopes

How to Cite

Nagai, T., Taguchi, K., Isobe, T., Matsuyama, N., Hattori, T., Unno, R., Kato, T., Etani, T., Hamakawa, T., Fujii, Y., Ikegami, Y., Kamiya, H., Hamamoto, S., Nakane, A., Ando, R., Maruyama, T., Okada, A., Kawai, N., & Yasui, T. (2023). A Multicenter, Prospective, Non-randomized Study Evaluating Surgical hand Preparation between Double-Gloving and Single-Gloving for Preventing Postoperative Infection in Robotic and Laparoscopic Minimally Invasive Surgeries. Urology Journal, 20(02), 109-115. https://doi.org/10.22037/uj.v19i.7239

References

Kolasiński W. Surgical site infections - review of current knowledge, methods of prevention. Pol Przegl Chir. 2018; 91:41-47.

Anderson DJ, Podgorny K, Berríos-Torres SI et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol 2014; 35:605-627.

Shen NJ, Pan SC, Sheng WH, Tien KL, Chen ML, Chang SC, Chen YC. Comparative antimicrobial efficacy of alcohol-based hand rub and conventional surgical scrub in a medical center. J Microbiol Immunol Infect. 2015; 48:322-328.

Rotter ML. Arguments for alcoholic hand disinfection. J Hosp Infect. 2001; 48:S4-S8.

Parienti JJ, Thibon P, Heller R et al. Hand-rubbing with an aqueous alcoholic solution vs traditional surgical hand-scrubbing and 30-day surgical site infection rates: a randomized equivalence study. 2002; JAMA 288:722-727.

Oriel BS, Itani KM. Surgical hand antisepsis and surgical site infections. Surg Infect (Larchmt) 2006; 17:632-644.

Tanner J, Parkinson H. Double gloving to reduce surgical cross-infection. Cochrane Database Syst Rev 2006:CD003087.

World Health Organization (updated 2018) Global guidelines for the prevention of surgical site infection. https://apps.who.int/iris/bitstream/handle/10665/250680/9789241549882-eng.pdf?sequence=8. Accessed 11 Mar 2022

Yamamoto S, Shigemura K, Kiyota H et al. Essential Japanese guidelines for the prevention of perioperative infections in the urological field: 2015 edition. 2016; Int J Urol 23:814-824.

Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR (1999) Guideline for prevention of surgical site infection. Centers for Disease Control and Prevention (CDC) hospital infection control practices advisory committee. 1999; Am J Infect Control 27:97-132; quiz 133.

Bailey IS, Karran SE, Toyn K, Brough P, Ranaboldo C, Karran SJ. Community surveillance of complications after hernia surgery. 1992; BMJ 304:469-471.

George AK, Srinivasan AK, Cho J, Sadek MA, Kavoussi LR. Surgical site infection rates following laparoscopic urological procedures. 2011; J Urol 185:1289-1293.

Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. 2013; Bone Marrow Transplant 48:452-458.

Korol E, Johnston K, Waser N, Sifakis F, Jafri HS, Lo M, Kyaw MH. A systematic review of risk factors associated with surgical site infections among surgical patients. 2013; PLoS One 8:e83743.

Tollefson MK, Frank I, Gettman MT. Robotic-assisted radical prostatectomy decreases the incidence and morbidity of surgical site infections. 2011; Urology 78:827-831.

Shigemura K, Tanaka K, Yamamichi F, Muramaki M, Arakawa S, Miyake H, Fujisawa M. Comparison of postoperative infection between robotic-assisted laparoscopic prostatectomy and open radical prostatectomy. 2014; Urol Int 92:15-19.

de Vermandois JAR, Cochetti G, Zingaro MD et al. Evaluation of surgical site infection in mini-invasive urological surgery. 2019; Open Med (Wars) 14:711-718.

Gross K. Postoperative fever. In: Saclarides TJ, Myers JA, Millikan KW (eds). Common surgical diseases: an algorithmic approach to problem solving, 3rd edn. 2015; Springer, New York, pp 341-342

Larson EL, Aiello AE, Heilman JM, Lyle CT, Cronquist A, Stahl JB, Della-Latta P. Comparison of different regimens for surgical hand preparation. 2001; AORN J 73:412-324, 417.

Pietsch H. Hand antiseptics: rubs versus scrubs, alcoholic solutions versus alcoholic gels. 2001; J Hosp Infect 48:S33–S36.

Thomas S, Agarwal M, Mehta G. Intraoperative glove perforation - single versus double gloving in protection against skin contamination. 2001; Postgrad Med J 77:458-460.

Lancaster C, Duff P. Single versus double-gloving for obstetric and gynecologic procedures. 2007; Am J Obstet Gynecol 196:e36–e37.

Unno R, Taguchi K, Fujii Y et al. Surgical hand hygiene and febrile urinary tract infections in endourological surgery: a single-centre prospective cohort study. 2020, Sci Rep 10:14520.

Mischke C, Verbeek JH, Saarto A, Lavoie MC, Pahwa M, Ijaz S. Gloves, extra gloves or special types of gloves for preventing percutaneous exposure injuries in healthcare personnel. 2014, Cochrane Database Syst Rev (3):CD009573.

Birnbach DJ, Rosen LF, Fitzpatrick M, Carling P, Arheart KL, Munoz-Price LS. Double gloves: a randomized trial to evaluate a simple strategy to reduce contamination in the operating room. 2015, Anesth Analg 120:848-852.

Casanova LM, Rutala WA, Weber DJ, Sobsey MD. Effect of single- versus double-gloving on virus transfer to health care workers’ skin and clothing during removal of personal protective equipment. 2012, Am J Infect Control 40:369-374.

Moog P, Schulz M, Betzl J et al. Do your surgical glove characteristics and wearing habits affect your tactile sensibility? 2020, Ann Med Surg (Lond) 57:281-286.

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