Clinical question	Bottom-line answer
6. Use of sterile gloves Does the use of sterile gloves when performing minor outpatient cutaneous surgeries reduce the risk of infection?¹⁵	Sterile gloves offer no benefit for minor outpatient skin procedures. Eight studies with more than 2,700 patients found no difference in the risk of infection between sterile or nonsterile gloves for common outpatient skin procedures, such as laceration repair and lesion excision. The relative risk of infection was a nonsignificant 0.95 (95% confidence interval, 0.65 to 1.40).
7. Diagnosing onychomycosis Is confirmatory diagnostic testing cost-effective for the management of clinically suspected onychomycosis?¹⁶	Confirmatory testing is generally unnecessary for clinically suspected onychomycosis. The most cost-effective approach to a patient with clinically suspected onychomycosis is empiric therapy with oral terbinafine (Lamisil). The chance of liver injury is estimated to be only one in 50,000 to one in 120,000, so testing to confirm the diagnosis would cost tens of millions of dollars per case of liver injury avoided. If you plan to prescribe the less effective and much more expensive topical solution efinaconazole (Jublia), then confirmatory testing with periodic acid–Schiff stain reduces costs.

Clinical question

Bottom-line answer

6. Use of sterile gloves
Does the use of sterile gloves when performing minor outpatient cutaneous surgeries reduce the risk of infection?¹⁵

Sterile gloves offer no benefit for minor outpatient skin procedures.
Eight studies with more than 2,700 patients found no difference in the risk of infection between sterile or nonsterile gloves for common outpatient skin procedures, such as laceration repair and lesion excision. The relative risk of infection was a nonsignificant 0.95 (95% confidence interval, 0.65 to 1.40).

7. Diagnosing onychomycosis
Is confirmatory diagnostic testing cost-effective for the management of clinically suspected onychomycosis?¹⁶

Confirmatory testing is generally unnecessary for clinically suspected onychomycosis.
The most cost-effective approach to a patient with clinically suspected onychomycosis is empiric therapy with oral terbinafine (Lamisil). The chance of liver injury is estimated to be only one in 50,000 to one in 120,000, so testing to confirm the diagnosis would cost tens of millions of dollars per case of liver injury avoided. If you plan to prescribe the less effective and much more expensive topical solution efinaconazole (Jublia), then confirmatory testing with periodic acid–Schiff stain reduces costs.