Colored Indicator Undergloves Increase the Detection of Glove Perforations by Surgeons During Small Animal Orthopedic Surgery: A Randomized Controlled Trial

OBJECTIVE: To determine whether use of colored indicator gloves affects perforation detection rate and to identify risk factors for glove perforation during veterinary orthopedic surgery. STUDY DESIGN: Prospective randomized controlled trial. SAMPLE POPULATION: 574 double pairs of gloves worn during 300 orthopedic surgical procedures (2,296 gloves). METHODS: Primary and assistant surgeons double‐gloved for all orthopedic surgical procedures. Type of inner glove (standard or colored indicator) was randomized for the first 360 double pairs of gloves worn by surgeons during 180 procedures. Perforations detected by surgeons were recorded and gloves changed if requested. For a further 120 procedures, indicator gloves were used exclusively. All gloves were leak‐tested after surgery to identify perforations. Association between potential risk factors and perforation was explored using multivariate logistical regression analysis. RESULTS: Glove perforations occurred during 43% of surgeries with a mean of 2.3 holes/surgery. Inner gloves were intact in 63% of glove pairs where an outer perforation occurred. Intraoperative perforation detection was improved when colored indicator gloves were worn (83% sensitivity) vs. standard gloves (34% sensitivity; P<.001). Independent risk factors for perforation were placement of plates and/or screws (P=.001; OR=2.4; 95% CI, 1.4–4.0), placement of an external skeletal fixator (P=.002; OR=7.0; 95% CI, 2.1–23.8), use of orthopedic wire (P=.011; OR=2.4; 95% CI, 1.2–4.7), and primary surgeon being board‐certified (P=.016; OR=1.9; 95% CI, 1.1–3.1). CONCLUSION: Increased surgeon recognition of glove perforations through use of colored indicator gloves enables prompt change of gloves if perforation occurs and may reduce potential contamination of the surgical site.