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01.12.2014 | Research | Ausgabe 1/2014 Open Access

Patient Safety in Surgery 1/2014

Is the surgical knot tying technique associated with a risk for unnoticed glove perforation? An experimental study

Patient Safety in Surgery > Ausgabe 1/2014
Vincenzo Giordano, Hilton Augusto Koch, Juliano de Sousa Prado, Leonardo Schiavo de Morais, Rafael de Araújo Hara, Felipe Serrão de Souza, Ney Pecegueiro do Amaral
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1754-9493-8-26) contains supplementary material, which is available to authorized users.

Competing interests

There are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.

Authors’ contributions

VG and NPA designed the study and evaluated the results and drafted the first version of the manuscript. VG, JSP, LSM, and FSS performed the experiments. HAK contributed to revisions of the manuscript. All authors read and approved the final version of the manuscript.



The issue of safety in the surgical procedure has recently been widely and openly discussed at the World Health Organization. The use of latex gloves is the current standard of protection during surgery, as they remain intact throughout the procedure. The present study was designed to evaluate the rate of glove perforation during a two-hand technique using polyester sutures in a controlled experimental study.


Hypothesis was that the gloves used during a two-hand technique using polyester suture suffer punctures. We used 150 pairs of gloves during the experiment. Each investigator performed 30 tests always using double gloving. They made five surgical knots on each test over a custom-made table specifically developed for the experiment. Ten tests were done at a time with a week- interval. The Control Group (CG) has 30 pairs of intact surgical gloves. The gloves were tested to impermeability by water filling and leaking was observed at three different times. Statistics relating to the perforation rate were analyzed using the chi-square test. A P value less than 0.05 was considered statistically significant.


During the experiment there was no loss of gloves by drilling or inadvertent error in performing the impermeability test. No perforations were detected at any time during the impermeability test with the gloves used for sutures. Also, the CG presented no leakage of the liquid used for the test. There was no statistical difference between the groups underwent suture nor between them and the GC.


Under the studied conditions, the authors’ hypotheses could not be proved. There was no damage to the surgical gloves during the entire experiment. The authors believe that the skin abrasions observed in the ulnar side of the little finger, constant throughout the experiment, must be caused by friction. We feel there is no risk of perforation of surgical gloves during a two-hand technique using polyester suture.
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