Timing and Surgical Phases of Glove Perforation in Orthopedic Trauma Surgery: A Prospective Study
- 1University of Health Sciences Türkiye Balıkesir Atatürk City Hospital, Clinic of Orthopedics and Traumatology, Balıkesir, Türkiye
Abstract
Objective: To evaluate the frequency, timing, surgical-stage distribution, anatomical location, and factors associated with glove perforation during orthopaedic trauma surgery. Methods: This prospective study included 354 orthopaedic trauma procedures, categorized into small-bone, intermediate-bone, and large-bone fracture groups. A standardized double-gloving protocol was used, and outer gloves were assessed for perforation at 10-minute intervals using a saline inflation test. Timing, surgical stage, anatomical location, and hand dominance of the perforations were recorded. Results: Glove perforation occurred in 74 of 354 procedures (20.9%). Perforation rates increased significantly across procedure types: small-bone (10.2%), intermediate-bone (20.3%), and large-bone (32.2%) (p<0.001). Mean time to perforation was 32.4±11.9 minutes and differed significantly among fracture-size groups (p<0.001). Fracture reduction accounted for 48.6% of perforations, and the index finger was the most frequently affected site (54.1%). The dominant hand was involved in 67.6% of perforations. Inner-glove perforation occurred in six procedures (1.7%). Mean operative duration was longer in procedures with perforation than in those without (54.1 vs. 42.6 minutes; p<0.001). In multivariable analysis, each one-category increase in fracture bone size was associated with a 2.14-fold increase in the odds of perforation [95% confidence interval (CI), 1.52-3.01; p<0.001], while each additional minute of operative duration increased the odds by 6% (odds ratio 1.06; 95% CI, 1.03-1.09; p<0.001). Conclusion: Glove perforation is common during orthopaedic trauma surgery and is associated with larger fracture size and longer operative duration. Fracture reduction is the surgical stage most frequently implicated. These findings may help identify procedures and surgical phases requiring increased attention to glove integrity.
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BibTeX
@article{gok2026timing,
title = {{Timing and Surgical Phases of Glove Perforation in Orthopedic Trauma Surgery: A Prospective Study}},
author = {Murat GÖK and Ahmet Alp Eren KAVRUK and Özgün KARAKUŞ},
journal = {Forbes Tıp Dergisi},
year = {2026},
month = oct,
doi = {10.4274/forbes.galenos.2026.57778},
url = {https://doi.org/10.4274/forbes.galenos.2026.57778},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Timing and Surgical Phases of Glove Perforation in Orthopedic Trauma Surgery: A Prospective Study
AU - Murat GÖK
AU - Ahmet Alp Eren KAVRUK
AU - Özgün KARAKUŞ
PY - 2026
DA - 2026/10/23
JO - Forbes Tıp Dergisi
DO - 10.4274/forbes.galenos.2026.57778
UR - https://doi.org/10.4274/forbes.galenos.2026.57778
AB - Objective: To evaluate the frequency, timing, surgical-stage distribution, anatomical location, and factors associated with glove perforation during orthopaedic trauma surgery. Methods: This prospective study included 354 orthopaedic trauma procedures, categorized into small-bone, intermediate-bone, and large-bone fracture groups. A standardized double-gloving protocol was used, and outer gloves were assessed for perforation at 10-minute intervals using a saline inflation test. Timing, surgical stage, anatomical location, and hand dominance of the perforations were recorded. Results: Glove perforation occurred in 74 of 354 procedures (20.9%). Perforation rates increased significantly across procedure types: small-bone (10.2%), intermediate-bone (20.3%), and large-bone (32.2%) (p<0.001). Mean time to perforation was 32.4±11.9 minutes and differed significantly among fracture-size groups (p<0.001). Fracture reduction accounted for 48.6% of perforations, and the index finger was the most frequently affected site (54.1%). The dominant hand was involved in 67.6% of perforations. Inner-glove perforation occurred in six procedures (1.7%). Mean operative duration was longer in procedures with perforation than in those without (54.1 vs. 42.6 minutes; p<0.001). In multivariable analysis, each one-category increase in fracture bone size was associated with a 2.14-fold increase in the odds of perforation [95% confidence interval (CI), 1.52-3.01; p<0.001], while each additional minute of operative duration increased the odds by 6% (odds ratio 1.06; 95% CI, 1.03-1.09; p<0.001). Conclusion: Glove perforation is common during orthopaedic trauma surgery and is associated with larger fracture size and longer operative duration. Fracture reduction is the surgical stage most frequently implicated. These findings may help identify procedures and surgical phases requiring increased attention to glove integrity.
SN - 2757-5241
ER -