通过外科手套孔洞的细菌浓度（翻译有奖）

潮水

美国感染控制杂志2010年第2期
Concentration of bacteria passing through puncture holes in surgical gloves
Background
The reasons for gloving-up for surgery are to protect the surgical field from microorganisms on the surgeon's hands and protect the surgeon from the patient's microorganisms. This study measured the concentration of bacteria passing through glove punctures under surgical conditions.

Methods
Double-layered surgical gloves were worn during visceral surgeries over a 4-month period. The study included 128 outer gloves and 122 inner gloves from 20 septic laparotomies. To measure bacterial passage though punctures, intraoperative swabs were made, yielding microorganisms that were compared with microorganisms retrieved from the inner glove layer using a modified Gaschen bag method.

Results
Depending on the duration of glove wear, the microperforation rate of the outer layer averaged 15%. Approximately 82% of the perforations went unnoticed by the surgical team. Some 86% of perforations occurred in the nondominant hand, with the index finger being the most frequently punctured location (36%). Bacterial passage from the surgical site through punctures was detected in 4.7% of the investigated gloves.

Conclusion
Depending on the duration of wear, surgical gloves develop microperforations not immediately recognized by staff. During surgery, such perforations allow passage of bacteria from the surgical site through the punctures. Possible strategies for preventing passage of bacteria include strengthening of glove areas prone to punctures and strict glove changing every 90 minutes.

潘云娟

怎么只有摘要？没有主体内容？

潮水

回复 2# 潘云娟
新出版的杂志，没有全文权限！

wjllulu

为争取第一个“骗取”奖励，匆匆翻译，不怕现丑、水平不高，错误定有。                                       

                           　　　　对细菌穿过外科手套破损孔的观察
    背景：外科手术戴手套是为保护术者手上的微生物不污染手术野，同时，保护术者免受病人携带的微生物感染。本研究观测了在手术中手套破孔后细菌的穿透情况。
    方法：在使用双层手套进行内脏手术的“四个月的观察周期”中，共进行了２０台化脓性剖腹手术，其中观察了128个外层手套和122个内层手套。为观测细菌通过穿刺孔处的情况，我们制作了术中拭子“收取”微生物，同时将其与在内层手套中使用改良Gaschen袋法收集到的微生物进行了比较。
    结果：在观察期间发现，外层手套的微穿孔率平均为15%。大约82%的穿孔未被手术人员所警觉。约86%的穿孔发生在非惯用手部位，食指部位是最常发生手套穿孔的位置（36%）。在所观察的手套中，４.７％被发现有细菌从手术部位穿过手套破孔处。
    结论：在外科手套使用过程中发生的微穿孔情况往往没有立即被工作人员所察觉。在手术中，这种微小穿孔可使手术部位的细菌通过穿刺孔。为防止这种细菌的穿透，可考虑的战略应包括对手套容易穿孔部位增加加固层，同时，严格遵守每90分钟更换手套制度。

潮水

1、增加加固层
2、手术中90分钟更换一次手套
可行性如何？

楚楚

回复 1# 潮水
２０台化脓性剖腹手术，研究的不是日常认为手套容易破损的手术，如骨科手术等，如果进行骨科手术的话，破损的可能性会更高？
WHO医务人员手卫生指南中指出，进行骨科手术等时建议带双层手套。依从性高吗？是不是更需要从提高手套的质量入手？

ruiyizhu

同意潮水老师的观点，挺难实现的。

chenliliang

外层手套的微穿孔率平均为15%。很有意义的警示数据。

镜中月

外层手套的微穿孔,嗯，平时所忽视的问题。谢谢老师的分享

mtara

手中刚好有这篇文章，补上附件