Revista de Enfermagem em Cuidados Intensivos Perioperatórios e Críticos
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Increased Safety of Surgical Glove Application: The Under/Over Method

Paul H Sugarbaker

Background: Surgical gloves are a necessity in performing abdominal and pelvic surgery not only to protect the patient from bacterial contamination but also to protect the surgeon, the nurses and surgical assistants from biological fluids. The interface of the surgical gown and the surgical gloves at the wrist is a site for interruption of the barrier between biological fluids in the open abdomen and the surgeon. Methods: In the under/over method (UOM) for double-glove application the first pair of gloves are positioned under the surgical gown and the second pair are positioned over the cuff of the surgical gown and secured with selfadherent wrap. Results: Using the UOM, the proximal portion of the surgical gloves did not roll down to the wrist. The selfadherent wrap reduced the entrance of biological fluids into the space between the surgical gloves and the cuff of the surgical gown. If the cuff of the surgical gown became wet, it was not in contact with the wrist skin. Conclusion: The UOM prevents the surgical gloves from rolling down on the forearm. Contact of the cuff of the surgical gown with the wrist skin is prevented. The possibility of exposure of the wrist skin to biological fluids, especially large volume irrigation, during abdominal and pelvic surgery may be reduced.