The use of sterile gloves when treating wounds has long been considered a standard practice to prevent infections. However, a recent meta-analysis of randomized trials is challenging this notion. According to the pooled results of four randomized controlled trials (RCTs), there is no significant difference in the risk of surgical site infections when using sterile or nonsterile gloves to repair wounds. The findings of this analysis, published in JAMA Surgery, raise questions about the necessity and effectiveness of using sterile gloves in certain wound repair scenarios.
Clinical practice guidelines recommend the use of sterile gloves to prevent infections during wound repair. However, the researchers behind the meta-analysis argue that there is no clear evidence supporting the superiority of sterile gloves over nonsterile gloves in reducing the risk of infections, particularly for simple wounds. The study’s lead author, Dr. Loai Albarqouni, emphasizes the need to reevaluate the existing guidelines and the assumptions behind them. He notes that the evidence gathered in their analysis pertains specifically to clean wound repairs and may not be applicable to other types of injuries.
Dr. Albarqouni and his team conducted a systematic review of RCT evidence to examine the impact of sterile versus nonsterile gloves on surgical site infection rates in the context of wound repair. The analysis included six RCTs and a total of 6,182 patients. Notably, most of the studies reported the use of other sterile techniques in both the sterile and nonsterile glove groups, such as disinfectants and sterile instruments.
No Difference in Infection Outcomes
The meta-analysis revealed moderate-certainty evidence that the type of glove used had no significant impact on infection outcomes. Whether it was a typical wound repair or other types of wounds related to trauma, dermatological, or plastic surgery, the findings remained consistent. The risk of surgical site infections did not differ significantly between the use of sterile and nonsterile gloves.
In addition to questioning the necessity of sterile gloves, the study also highlighted the potential cost-effectiveness of using nonsterile gloves for wound repair. The researchers found that using nonsterile gloves was a more economical option compared to sterile gloves, especially for minor wounds and lacerations. Nonsterile gloves are typically cheaper to produce due to fewer production steps involved in ensuring their sterility. In contrast, the cost of sterile gloves can be up to four times higher.
Resource Allocation and Smart Choices
Dr. Albarqouni emphasizes the importance of considering healthcare resource limitations and making smart choices when it comes to allocating resources. In places where healthcare resources are limited, such as developing countries or underfunded healthcare systems, the switch to nonsterile gloves may be a reasonable choice. By opting for nonsterile gloves, which have shown to be equally effective in preventing infections, healthcare providers can allocate the saved resources to more essential treatments and interventions that have strong evidence supporting their efficacy.
The use of sterile gloves during wound repair has long been considered standard practice, but the recent meta-analysis challenges the necessity and efficacy of this practice, particularly for simple, clean wound repairs. The findings suggest that sterile gloves may not offer significant advantages over nonsterile gloves in preventing surgical site infections. Moreover, the cost-effectiveness of nonsterile gloves makes them a feasible option, especially in resource-limited settings. As healthcare providers strive to achieve the best results with the available resources, critical evaluation of guidelines and evidence-based practices is vital for informed decision-making in wound treatment.