Ditch Sterile Gloves When Treating Wounds?

Use of sterile gloves might not be necessary to prevent infections when treating wounds, a meta-analysis of randomized trials found.

Pooled results from four randomized controlled trials (RCTs), with moderate-certainty evidence, showed no significant difference in the risk of surgical site infections whether using sterile or nonsterile gloves to repair wounds (RR 1.17, 95% CI 0.88-1.55, P=0.62), Loai Albarqouni, MD, MSc, PhD, of Bond University in Queensland, Australia, and colleagues reported in a research letter in JAMA Surgery.

“We’re reasonably confident that using sterile gloves for fixing wounds doesn’t seem to make much of a difference in preventing infections compared to using clean gloves,” Albarqouni told MedPage Today in an email. “However, it’s essential to note that this conclusion is specific to simple, clean wound repairs and may not apply to other types of injuries.”

While clinical practice guidelines recommend using sterile gloves to prevent infections, there’s no clear evidence that nonsterile gloves are less effective at reducing that risk, particularly when it comes to simple wounds, the researchers explained.

“When fixing cuts or injuries in emergency rooms, it’s common to use super-clean gloves to lower the chance of infections,” Albarqouni said. “But there’s some doubt about whether using super-clean gloves actually makes a big difference compared to just using regular, clean gloves. That’s why we did a careful review of all the evidence out there to figure it out.”

He and his colleagues conducted a systematic review of RCT evidence looking at the effect on surgical site infection rates of sterile versus nonsterile gloves for repairing lacerations and wounds.

They included RCTs that evaluated these effects in minor surgical procedures in emergency, primary care, and outpatient settings, ultimately including six RCTs totaling 6,182 patients. Most studies reported the use of other sterile techniques in both sterile and nonsterile glove groups, including disinfectants and sterile instruments.

In addition to the findings on typical wound repairs, Albarqouni and colleagues also looked at other types of wounds, including those related to trauma and dermatological or plastic surgery. They similarly found moderate-certainty evidence that there was no difference in infection outcomes no matter which type of glove was used (RR 1.17, 95% CI 0.89-1.55, P=0.26).

Two studies also found that using nonsterile gloves was a cost-effective option, compared with sterile gloves, for repairing minor wounds and lacerations.

“Nonsterile clean gloves are usually cheaper than super-clean sterile gloves because making the sterile ones involves more steps,” such as “making sure they’re completely germ-free, putting them in special packaging, and meeting high-quality standards,” Albarqouni said. “So, in simple terms, the super-clean gloves end up costing more — about four times more, to be exact. For example, you might pay around AUD $80 [$53 USD] for 50 super-clean gloves, while you’d only pay about AUD $20 [$13 USD] for the regular ones.”

He and his team noted that in places where healthcare resources become limited, switching to nonsterile gloves may be a reasonable choice.

“In places where resources are limited and money needs to be wisely spent on treatments that have proven to work well, it makes sense to consider the costs,” said Albarqouni. “Instead of spending extra money on things like super-clean gloves, which might not make a big difference in preventing infections, that money could be better used for treatments and interventions that we know are effective based on strong evidence.”

“It’s about making smart choices to get the best results with the resources available,” he said.

In addition, he and his team wrote in their paper, “sterile gloves’ consumption of energy and resources impacts the environment, a crucial concern for healthcare systems striving for sustainability.”

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