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Knot tying in arthroplasty and arthroscopy causes lesions to surgical gloves: a potential risk of infection

PURPOSE: Recent studies have shown that the incidence of glove lesions during arthroscopy is much lower than that during primary and revision arthroplasty. However, the rate of glove damage after knot tying has not yet been systematically recorded. Therefore, the aim of the study was to determine th...

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Autores principales: Enz, Andreas, Klinder, Annett, Bisping, Lucas, Lutter, Christoph, Warnke, Philipp, Tischer, Thomas, Mittelmeier, Wolfram, Lenz, Robert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10089991/
https://www.ncbi.nlm.nih.gov/pubmed/36048202
http://dx.doi.org/10.1007/s00167-022-07136-7
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author Enz, Andreas
Klinder, Annett
Bisping, Lucas
Lutter, Christoph
Warnke, Philipp
Tischer, Thomas
Mittelmeier, Wolfram
Lenz, Robert
author_facet Enz, Andreas
Klinder, Annett
Bisping, Lucas
Lutter, Christoph
Warnke, Philipp
Tischer, Thomas
Mittelmeier, Wolfram
Lenz, Robert
author_sort Enz, Andreas
collection PubMed
description PURPOSE: Recent studies have shown that the incidence of glove lesions during arthroscopy is much lower than that during primary and revision arthroplasty. However, the rate of glove damage after knot tying has not yet been systematically recorded. Therefore, the aim of the study was to determine the impact of surgical knot tying on glove integrity. It was hypothesized that knot tying increases the rate of glove damage, especially in arthroscopic surgery, which could be of special relevance in the treatment of rotator cuff tears. METHODS: Gloves that were changed immediately before suturing and only worn during knot tying were investigated for their integrity by means of water tightening test according to EN455. A total of 234 gloves from 40 total hip arthroplasties (THAs), 42 total knee arthroplasties (TKAs) and 36 rotator cuff repairs (RCRs) were collected. A bacterial pass-through test (BPTT) on glove lesions was performed under simulated sterile surgical conditions for 3 surgeons after a wear duration of 45 min. RESULTS: Glove damage by knot tying occurred in 25% of THA, 36.6% of TKA and 25% of RCR surgeries. In THA, the pulling hand (PH) was affected in 46.2%, and the main area of damage (15.4%) was detected on the tip of the middle finger; in TKAs the PH was damaged in 75%, and in RCRs the PH was affected in 66.7%, with most of the lesions (20% each) occurring on the tip of the index finger and the ring finger. The BPTT showed Staphylococcus hominis and Bacillus cereus. CONCLUSION: Intraoperative knot tying causes damage to gloves, which is of special relevance for arthroscopic surgery. Whereas knot tying is only partly responsible for glove damage in arthroplasty, the general rate of glove damage in arthroscopic surgery is low without knot tying. The surgical knot tying process must be understood as a possible damaging impact on the glove. Therefore, single gloving is not recommended, which is especially important in arthroscopic surgery, where double gloving is not yet standard. LEVEL OF EVIDENCE: IV. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00167-022-07136-7.
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spelling pubmed-100899912023-04-13 Knot tying in arthroplasty and arthroscopy causes lesions to surgical gloves: a potential risk of infection Enz, Andreas Klinder, Annett Bisping, Lucas Lutter, Christoph Warnke, Philipp Tischer, Thomas Mittelmeier, Wolfram Lenz, Robert Knee Surg Sports Traumatol Arthrosc Knee PURPOSE: Recent studies have shown that the incidence of glove lesions during arthroscopy is much lower than that during primary and revision arthroplasty. However, the rate of glove damage after knot tying has not yet been systematically recorded. Therefore, the aim of the study was to determine the impact of surgical knot tying on glove integrity. It was hypothesized that knot tying increases the rate of glove damage, especially in arthroscopic surgery, which could be of special relevance in the treatment of rotator cuff tears. METHODS: Gloves that were changed immediately before suturing and only worn during knot tying were investigated for their integrity by means of water tightening test according to EN455. A total of 234 gloves from 40 total hip arthroplasties (THAs), 42 total knee arthroplasties (TKAs) and 36 rotator cuff repairs (RCRs) were collected. A bacterial pass-through test (BPTT) on glove lesions was performed under simulated sterile surgical conditions for 3 surgeons after a wear duration of 45 min. RESULTS: Glove damage by knot tying occurred in 25% of THA, 36.6% of TKA and 25% of RCR surgeries. In THA, the pulling hand (PH) was affected in 46.2%, and the main area of damage (15.4%) was detected on the tip of the middle finger; in TKAs the PH was damaged in 75%, and in RCRs the PH was affected in 66.7%, with most of the lesions (20% each) occurring on the tip of the index finger and the ring finger. The BPTT showed Staphylococcus hominis and Bacillus cereus. CONCLUSION: Intraoperative knot tying causes damage to gloves, which is of special relevance for arthroscopic surgery. Whereas knot tying is only partly responsible for glove damage in arthroplasty, the general rate of glove damage in arthroscopic surgery is low without knot tying. The surgical knot tying process must be understood as a possible damaging impact on the glove. Therefore, single gloving is not recommended, which is especially important in arthroscopic surgery, where double gloving is not yet standard. LEVEL OF EVIDENCE: IV. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00167-022-07136-7. Springer Berlin Heidelberg 2022-09-01 2023 /pmc/articles/PMC10089991/ /pubmed/36048202 http://dx.doi.org/10.1007/s00167-022-07136-7 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Knee
Enz, Andreas
Klinder, Annett
Bisping, Lucas
Lutter, Christoph
Warnke, Philipp
Tischer, Thomas
Mittelmeier, Wolfram
Lenz, Robert
Knot tying in arthroplasty and arthroscopy causes lesions to surgical gloves: a potential risk of infection
title Knot tying in arthroplasty and arthroscopy causes lesions to surgical gloves: a potential risk of infection
title_full Knot tying in arthroplasty and arthroscopy causes lesions to surgical gloves: a potential risk of infection
title_fullStr Knot tying in arthroplasty and arthroscopy causes lesions to surgical gloves: a potential risk of infection
title_full_unstemmed Knot tying in arthroplasty and arthroscopy causes lesions to surgical gloves: a potential risk of infection
title_short Knot tying in arthroplasty and arthroscopy causes lesions to surgical gloves: a potential risk of infection
title_sort knot tying in arthroplasty and arthroscopy causes lesions to surgical gloves: a potential risk of infection
topic Knee
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10089991/
https://www.ncbi.nlm.nih.gov/pubmed/36048202
http://dx.doi.org/10.1007/s00167-022-07136-7
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