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Double-Gloving Surgical Gloves: Does It Provide Significant Benefits?*

by Deborah Davis, MS, MBA

Does double-gloving reduce the risk of exposure to bloodborne pathogens? A number of studies have evaluated the effectiveness of double-gloving in reducing the risk of skin contamination for surgeons. This article outlines some of these studies and their findings regarding the key issues of sensibility, comfort and efficacy. Out of 46 studies reviewed, 21 significantly concluded that double-gloving did help prevent blood contact. Only five concluded that double-gloving had no impact on blood contact.

Perforation rates.
The perforation rates of single-gloving versus double-gloving methods were examined in several studies under a variety of conditions, including hip fracture operations, dermatological surgery and laparotomy procedures. Virtually all of the authors conclude that double-gloving significantly reduces the risk of skin contamination by blood and body fluids. In one trial of perineorrhaphy after vaginal delivery, the glove perforation rate of inner double gloves (2.7%) was significantly reduced compared with single gloves (6.7%). Two studies showed that lengthier operations are associated with increased risk of glove perforation and/or blood contamination. The authors of another study recommend further protection of the thumb and index finger of the surgeon's nondominant hand to reduce the perforation rate.

Tactile sensitivity and dexterity.
The impact of double-gloving on tactile sensitivity and dexterity also was assessed. One study found no significant differences in hand sensation when comparing single and double gloves. Another trial compared single gloves with various size combinations of double gloves and found that double gloves significantly protected against needle perforation of the inner glove when compared with single gloves. However, wearers reported significantly impaired comfort, sensitivity and dexterity, although their preferences for particular glove size combinations were not statistically significant. Another study compared the effects of double- versus single-gloving on tactile discrimination and dexterity in 17 surgeons of all grades and specialties. Results showed that double-gloving did not alter the ability to tie surgical knots or affect Dellon's moving two-point discrimination test.

Glove liners.
Glove liners were compared to single and double latex gloves for cut and puncture resistance and for relative manual dexterity and degree of sensibility. The liners were found to be superior in most cases to double-gloving in terms of cut and puncture resistance but showed no difference in sensibility. Another study compared the rates of glove perforation using double-latex-gloving with or without a disposable protective glove liner. Findings showed that liners greatly reduced the rate of perforation of the inner glove.

Glove sizing.
The size of gloves worn over or under when double-gloving may have an effect on comfort and dexterity. One study of 106 surgeons indicated that the majority preferred to wear their normal-size glove inside and a half-size-larger glove on the outside when double-gloving.

Conclusion.
Double-gloving is beneficial, especially when the patient has a transmissible virus or when procedures last more than two hours. For those who choose not to double-glove, these studies suggest the benefit of inspecting gloved hands frequently for signs of blood contamination and of changing gloves at regular intervals.


*Article published in Managing Infection Control, Volume Two, Issue 4, April 2002.

Note: The information provided here is for general educational purposes and is not a substitute for specific medical advice by a physician. The information, programs and policies reviewed here are for illustrative purposes only. Each healthcare institution should tailor its policies, guidelines and approach to its unique circumstances, taking into account its facilities, employees and patient population.

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