Comparison of Perforation Between Single and Double‐gloving in Perineorrhaphy After Vaginal Delivery: A Randomized Controlled Trial

EDITORIAL COMMENT: We accepted this paper for publication because all surgeons are concerned, or should be concerned, about the possibility of contracting hepatitis or the immunodeficiency virus due to contamination with the patient's blood when operating. It goes without saying that all surgeons should be immunized against hepatitis B. There have been a number of studies recommending double‐gloving either as a routine or in high‐risk patients. We believe the Royal Australian and New Zealand College of Surgeons video recommends double‐gloving as a routine! There have been comments that double‐gloving causes clumsiness which could indeed be counter‐productive in rendering glove perforation more likely. However the reviewer of this paper made the point that with his experience with the double‐gloving technique the initial impression of clumsiness soon resolves. Summary: A prospective randomized controlled trial of single and double‐gloving methods in perineorrhaphy after vaginal delivery was performed between August 1, and September 30, 1996 at Rajavithi Hospital to compare glove perforation between both methods. We examined 1,316 individual gloves in the double‐gloving method and 742 individual gloves in the single‐gloving method. These gloves were tested by immersing in water. The glove perforation rate was 5.2% (107 of 2,058). There was significant reduction in the glove perforation rate of double‐inner gloves (2.7%) compared with the single‐gloving group (6.7%). The perforation rate of the double outer‐gloves group was 5.9%. The perforation rate in the matched outer and inner perforation was found only in 0.3% (2 of 658). The double‐gloving method had a significant benefit in protection of the surgeon's hand from the exposure to blood compared with the single‐gloving method.