Objectives
The two Cochrane reviews assessed different aspects of double-gloving and aimed to:
- Assess whether additional glove protection reduces the number of underglove perforations1
- Determine whether there is a clinically significant difference in using extra gloves for preventing needlestick injuries during surgery as well as to evaluate whether double gloving has a negative impact on the healthcare professional's hand skills (dexterity)2
Methodology
- Tanner et al, 2006, compared single-gloving, double-gloving and coloured puncture-indicating systems and included 31 randomised controlled trials measuring glove perforations1
- The review from 2014, included 34 randomised controlled trials measuring glove perforations. Increasing numbers of glove layers (single, double, triple) were evaluated2
- This review also included four additional gloving methods (glove liner, cloth overgloves, steel-weave overgloves and triple gloves)2
- Risk was determined through the measurement of perforations and self-reported needlestick injuries. Dexterity was measured via self-reporting and perforation rate2
Adapted from Tanner et al 2006
Results
10 studies in the Tanner review could be systematically reviewed for perforation rates in single versus double-gloving and demonstrated double-gloving was significantly more efficient in preventing perforations in the inner glove: 11% of single gloves perforated; 3% of undergloves perforated with double-gloving1.
Significantly more punctures were detected with Biogel Puncture Indication System gloves1.
Mischke et al also demonstrated that double-gloving significantly reduced the risk for innerglove perforation2. There was no significant difference in outer glove perforations between single- and double-gloving, indicating that there is no loss of dexterity with double gloves2.
The evidence from these two systematic reviews confirms that double-gloving provides better protection against blood contamination and inner glove perforations1,2.
