Comparison of sterile vs nonsterile gloves in cutaneous surgery and common outpatient dental procedures a systematic review and meta-analysis

Jerry D. Brewer, Alexandra B. Gonzalez, Christian Baum, Christopher J. Arpey, Randall K. Roenigk, Clark C. Otley, Patricia J. Erwin

Research output: Contribution to journalReview article

17 Citations (Scopus)

Abstract

IMPORTANCE Whether the use of sterile vs nonsterile gloves in outpatient cutaneous procedures affects the rate of postoperative wound infection is unknown. OBJECTIVE To explore rates of surgical site infection (SSI) with the use of sterile vs nonsterile gloves in outpatient cutaneous surgical procedures. DATA SOURCES This systematic review and meta-analysis identified studies from Ovid MEDLINE (1946 to present), Ovid Cochrane Central Register of Controlled Trials (1991 to present), Ovid EMBASE (1988 to present), EBSCO Cumulative Index to Nursing and Allied Health Literature (1980 to present), Scopus (1996 to present), andWeb of Science (1975 to present). STUDY SELECTION Studies with information on sterile vs nonsterile gloves in outpatient surgical procedures were retrieved. Only randomized clinical trials and comparative studies were included for final analysis. DATA EXTRACTION Data of trial design, surgery characteristics, and outcomes from published manuscripts and unpublished data were independently extracted. MAIN OUTCOMES AND MEASURES Randomized clinical trialswere considered high quality if randomization, allocation concealment, blinding, and follow-up completeness were appropriate. Relative risk and 95%CIs were derived for postoperative wound infections. RESULTS Fourteen articlesmet eligibility and inclusion criteria for systematic review; they included 12 275 unique patients who had undergone 12 275 unique outpatient procedures with sterile or nonsterile gloves and had follow-up regarding SSI. With the exclusion of 1 single-arm observational study of 1204 patients, 11 071 patients from 13 studies remained in the meta-analysis. Of these, 228 patients were documented as having postoperative SSI (2.1%), including 107 of 5031 patients in the nonsterile glove group (2.1%) and 121 of 6040 patients in the sterile glove group (2.0%). Overall relative risk for SSI with nonsterile glove use was 1.06 (95%CI, 0.81-1.39). CONCLUSIONS AND RELEVANCE No difference was found in the rate of postoperative SSI between outpatient surgical procedures performed with sterile vs nonsterile gloves.

Original languageEnglish (US)
Pages (from-to)1008-1014
Number of pages7
JournalJAMA Dermatology
Volume152
Issue number9
DOIs
StatePublished - Sep 1 2016

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Dermatologic Surgical Procedures
Surgical Wound Infection
Meta-Analysis
Tooth
Outpatients
Manuscripts
Random Allocation
MEDLINE
Observational Studies
Nursing
Randomized Controlled Trials
Skin
Health

ASJC Scopus subject areas

  • Dermatology

Cite this

Comparison of sterile vs nonsterile gloves in cutaneous surgery and common outpatient dental procedures a systematic review and meta-analysis. / Brewer, Jerry D.; Gonzalez, Alexandra B.; Baum, Christian; Arpey, Christopher J.; Roenigk, Randall K.; Otley, Clark C.; Erwin, Patricia J.

In: JAMA Dermatology, Vol. 152, No. 9, 01.09.2016, p. 1008-1014.

Research output: Contribution to journalReview article

Brewer, Jerry D. ; Gonzalez, Alexandra B. ; Baum, Christian ; Arpey, Christopher J. ; Roenigk, Randall K. ; Otley, Clark C. ; Erwin, Patricia J. / Comparison of sterile vs nonsterile gloves in cutaneous surgery and common outpatient dental procedures a systematic review and meta-analysis. In: JAMA Dermatology. 2016 ; Vol. 152, No. 9. pp. 1008-1014.
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abstract = "IMPORTANCE Whether the use of sterile vs nonsterile gloves in outpatient cutaneous procedures affects the rate of postoperative wound infection is unknown. OBJECTIVE To explore rates of surgical site infection (SSI) with the use of sterile vs nonsterile gloves in outpatient cutaneous surgical procedures. DATA SOURCES This systematic review and meta-analysis identified studies from Ovid MEDLINE (1946 to present), Ovid Cochrane Central Register of Controlled Trials (1991 to present), Ovid EMBASE (1988 to present), EBSCO Cumulative Index to Nursing and Allied Health Literature (1980 to present), Scopus (1996 to present), andWeb of Science (1975 to present). STUDY SELECTION Studies with information on sterile vs nonsterile gloves in outpatient surgical procedures were retrieved. Only randomized clinical trials and comparative studies were included for final analysis. DATA EXTRACTION Data of trial design, surgery characteristics, and outcomes from published manuscripts and unpublished data were independently extracted. MAIN OUTCOMES AND MEASURES Randomized clinical trialswere considered high quality if randomization, allocation concealment, blinding, and follow-up completeness were appropriate. Relative risk and 95{\%}CIs were derived for postoperative wound infections. RESULTS Fourteen articlesmet eligibility and inclusion criteria for systematic review; they included 12 275 unique patients who had undergone 12 275 unique outpatient procedures with sterile or nonsterile gloves and had follow-up regarding SSI. With the exclusion of 1 single-arm observational study of 1204 patients, 11 071 patients from 13 studies remained in the meta-analysis. Of these, 228 patients were documented as having postoperative SSI (2.1{\%}), including 107 of 5031 patients in the nonsterile glove group (2.1{\%}) and 121 of 6040 patients in the sterile glove group (2.0{\%}). Overall relative risk for SSI with nonsterile glove use was 1.06 (95{\%}CI, 0.81-1.39). CONCLUSIONS AND RELEVANCE No difference was found in the rate of postoperative SSI between outpatient surgical procedures performed with sterile vs nonsterile gloves.",
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N2 - IMPORTANCE Whether the use of sterile vs nonsterile gloves in outpatient cutaneous procedures affects the rate of postoperative wound infection is unknown. OBJECTIVE To explore rates of surgical site infection (SSI) with the use of sterile vs nonsterile gloves in outpatient cutaneous surgical procedures. DATA SOURCES This systematic review and meta-analysis identified studies from Ovid MEDLINE (1946 to present), Ovid Cochrane Central Register of Controlled Trials (1991 to present), Ovid EMBASE (1988 to present), EBSCO Cumulative Index to Nursing and Allied Health Literature (1980 to present), Scopus (1996 to present), andWeb of Science (1975 to present). STUDY SELECTION Studies with information on sterile vs nonsterile gloves in outpatient surgical procedures were retrieved. Only randomized clinical trials and comparative studies were included for final analysis. DATA EXTRACTION Data of trial design, surgery characteristics, and outcomes from published manuscripts and unpublished data were independently extracted. MAIN OUTCOMES AND MEASURES Randomized clinical trialswere considered high quality if randomization, allocation concealment, blinding, and follow-up completeness were appropriate. Relative risk and 95%CIs were derived for postoperative wound infections. RESULTS Fourteen articlesmet eligibility and inclusion criteria for systematic review; they included 12 275 unique patients who had undergone 12 275 unique outpatient procedures with sterile or nonsterile gloves and had follow-up regarding SSI. With the exclusion of 1 single-arm observational study of 1204 patients, 11 071 patients from 13 studies remained in the meta-analysis. Of these, 228 patients were documented as having postoperative SSI (2.1%), including 107 of 5031 patients in the nonsterile glove group (2.1%) and 121 of 6040 patients in the sterile glove group (2.0%). Overall relative risk for SSI with nonsterile glove use was 1.06 (95%CI, 0.81-1.39). CONCLUSIONS AND RELEVANCE No difference was found in the rate of postoperative SSI between outpatient surgical procedures performed with sterile vs nonsterile gloves.

AB - IMPORTANCE Whether the use of sterile vs nonsterile gloves in outpatient cutaneous procedures affects the rate of postoperative wound infection is unknown. OBJECTIVE To explore rates of surgical site infection (SSI) with the use of sterile vs nonsterile gloves in outpatient cutaneous surgical procedures. DATA SOURCES This systematic review and meta-analysis identified studies from Ovid MEDLINE (1946 to present), Ovid Cochrane Central Register of Controlled Trials (1991 to present), Ovid EMBASE (1988 to present), EBSCO Cumulative Index to Nursing and Allied Health Literature (1980 to present), Scopus (1996 to present), andWeb of Science (1975 to present). STUDY SELECTION Studies with information on sterile vs nonsterile gloves in outpatient surgical procedures were retrieved. Only randomized clinical trials and comparative studies were included for final analysis. DATA EXTRACTION Data of trial design, surgery characteristics, and outcomes from published manuscripts and unpublished data were independently extracted. MAIN OUTCOMES AND MEASURES Randomized clinical trialswere considered high quality if randomization, allocation concealment, blinding, and follow-up completeness were appropriate. Relative risk and 95%CIs were derived for postoperative wound infections. RESULTS Fourteen articlesmet eligibility and inclusion criteria for systematic review; they included 12 275 unique patients who had undergone 12 275 unique outpatient procedures with sterile or nonsterile gloves and had follow-up regarding SSI. With the exclusion of 1 single-arm observational study of 1204 patients, 11 071 patients from 13 studies remained in the meta-analysis. Of these, 228 patients were documented as having postoperative SSI (2.1%), including 107 of 5031 patients in the nonsterile glove group (2.1%) and 121 of 6040 patients in the sterile glove group (2.0%). Overall relative risk for SSI with nonsterile glove use was 1.06 (95%CI, 0.81-1.39). CONCLUSIONS AND RELEVANCE No difference was found in the rate of postoperative SSI between outpatient surgical procedures performed with sterile vs nonsterile gloves.

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