Gloves |

Cochrane reviews on double-gloving

The efficacy of double-gloving to reduce the risk of an inner-glove perforation and increase the detection of perforations when they occurred has been evaluated in two different Cochrane systematic reviews 1 2.

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 perforations 1
  • The review from 2014, included 34 randomised controlled trials measuring glove perforations. Increasing numbers of glove layers (single, double, triple) were evaluated 2
  • 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 rate 2

Illustration

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-gloving. 1  

Significantly more punctures were detected with Biogel Puncture Indication System gloves. 1 

Mischke et al also demonstrated that double-gloving significantly reduced the risk for innerglove perforation.2  There was no significant difference in outer glove perforations between single- and double-gloving, indicating that there is no loss of dexterity with double gloves. 2  

The evidence from these two systematic reviews confirms that double-gloving provides better protection against blood contamination and inner glove perforations. 1 2 

    1. Tanner J, et al. Double gloving to reduce surgical cross-infection. Cochrane Database Syst Rev. 2006 [cited 14 Sep 2017];(3):CD003087. URL: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003087.pub2/full.
    2. Mischke C, et al. Gloves, extra gloves or special types of gloves for preventing percutaneous exposure injuries in healthcare personnel. Cochrane Database Syst Rev. 2014 [cited 14 Sep 2017];(3):CD009573. URL: doi:10.1002/14651858.CD009573.pub2.

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