POEMs

Sterile Gloves Not Necessary for Minor Skin Surgery

 

Am Fam Physician. 2015 Jun 15;91(12):872a-877.

Clinical Question

Do sterile gloves yield lower wound infection rates than clean nonsterile gloves during minor skin surgery?

Bottom Line

Infection rates in patients undergoing uncomplicated minor skin surgery were not different when sterile gloves, rather than simply clean gloves, were worn. A previous study (Perelman VS, et al. Ann Emerg Med. 2004;43(3):362–370) similarly found no difference in infection rates between sterile and nonsterile gloves in patients undergoing uncomplicated laceration repair in the emergency department. (Level of Evidence = 1b)

Synopsis

These investigators enrolled 493 consecutive patients presenting to a general practice in Australia for minor skin excisions. Exclusion criteria included needing skin flaps, excision of a sebaceous cyst, and a history of latex allergy. Eligible patients randomly received (concealed allocation assignment) treatment by physicians wearing sterilized gloves or standard, boxed, nonsterilized gloves to perform the excision. Treating physicians were aware of the type of gloves they were wearing, and it is possible that they were more scrupulous with cleaning when wearing the nonsterile gloves. Follow-up was performed by a physician or nurse masked to treatment group assignment, with only 3% of cases lost. Using intention-to-treat analysis, infection occurred in 9.3% of patients treated with sterile gloves and 8.7% of patients treated with nonsterile gloves, a nonsignificant difference. The study was 80% powered as a noninferiority trial to detect a 7% difference in infection rates, if one existed.

Study design: Randomized controlled trial (single-blinded)

Funding source: Industry

Allocation: Concealed

Setting: Outpatient (primary care)

Reference: Heal C, Sriharan S, Buttner PG, Kimber D. Comparing non-sterile to sterile gloves for minor surgery: a prospective randomised controlled non-inferiority trial. Med J Aust. 2015; 202( 1): 27– 31.

POEMs (patient-oriented evidence that matters) are provided by EssentialEvidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP,search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

This series is coordinated by Sumi Sexton, MD, Associate Medical Editor.

A collection of POEMs published in AFP is available at http://www.aafp.org/afp/poems.


 

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