The use of sterile gloves has long been considered an essential practice in preventing infections during wound treatment. However, a recent meta-analysis of randomized trials challenges this conventional wisdom. The analysis, conducted by Loai Albarqouni, MD, MSc, PhD, and his team at Bond University in Queensland, Australia, suggests that the use of sterile gloves may not be necessary for preventing surgical site infections when repairing wounds.
No Significant Difference in Infection Rates
The pooled results from four randomized controlled trials, with moderate-certainty evidence, showed no significant difference in the risk of surgical site infections between the use of sterile and nonsterile gloves (RR 1.17, 95% CI 0.88-1.55, P=0.62). This finding challenges the commonly accepted notion that sterile gloves are more effective in reducing the risk of infections.
While clinical practice guidelines currently recommend the use of sterile gloves for infection prevention, there is limited evidence supporting their superiority over nonsterile gloves, particularly in the context of simple wound repairs. Albarqouni highlights the importance of distinguishing between different types of injuries, as the conclusions drawn from the study specifically apply to simple, clean wound repairs and may not be generalizable to other scenarios.
To evaluate the impact of sterile versus nonsterile gloves on infection rates, Albarqouni and his colleagues conducted a systematic review of randomized controlled trials. The analysis included a total of six trials, involving 6,182 patients. Most of the studies examined the use of other sterile techniques in addition to the gloves, such as disinfectants and sterile instruments.
In addition to simple wound repairs, the analysis also considered other types of injuries, including those related to trauma and dermatological or plastic surgery. The researchers found moderate-certainty evidence indicating no difference in infection outcomes regardless of the type of glove used (RR 1.17, 95% CI 0.89-1.55, P=0.26). This suggests that the choice between sterile and nonsterile gloves does not significantly impact infection rates across various wound treatment scenarios.
Furthermore, two studies included in the analysis demonstrated that using nonsterile gloves for minor wound repairs and lacerations can be a cost-effective option compared to sterile gloves. Nonsterile gloves are often less expensive to produce, as they do not require the same rigorous sterilization processes and packaging. Albarqouni explains that the price difference can be substantial, with super-clean sterile gloves costing about four times more than regular nonsterile gloves.
The cost-effectiveness of nonsterile gloves becomes particularly relevant in settings where healthcare resources are limited. Albarqouni suggests that investing in treatments and interventions with proven efficacy, rather than spending extra money on sterile gloves, is a more prudent approach. By making smart choices and allocating resources wisely, healthcare providers can maximize the impact of their interventions and optimize patient outcomes.
The findings of this meta-analysis challenge the established practice of using sterile gloves for wound treatment. While it is important to recognize the limitations of the study, particularly in relation to specific types of injuries, it prompts a reevaluation of current guidelines. It may be necessary to revise recommendations to better reflect the evidence and adapt practices to the availability of resources.
The use of sterile gloves for preventing infections during wound repairs may not be as crucial as previously believed. The results of this meta-analysis indicate that there is no significant difference in infection rates between sterile and nonsterile gloves, specifically for simple wound repairs. Additionally, nonsterile gloves offer a cost-effective alternative, particularly in settings with limited healthcare resources. This challenges the conventional wisdom and emphasizes the importance of critically evaluating established practices to ensure optimal patient care.