What are the benefits of wearing double gloves during a cesarean section (C-section)?

From the Guidelines

Double gloving during cesarean sections is highly recommended as it provides significant benefits for both healthcare providers and patients by reducing the risk of glove perforation and exposure to blood-borne pathogens. The practice involves wearing two pairs of surgical gloves, which reduces the risk of glove perforation by approximately 90% compared to single gloving, as noted by Quebbeman and colleagues in a prospective, randomized trial 1. When perforations occur in the outer glove, the inner glove typically remains intact, creating an effective barrier against blood-borne pathogens like HIV, hepatitis B, and hepatitis C.

Key Benefits of Double Gloving

• Reduces the risk of glove perforation and exposure to blood-borne pathogens
• Provides an effective barrier against blood-borne pathogens like HIV, hepatitis B, and hepatitis C
• Does not significantly impair tactile sensitivity after a brief adjustment period of about 10-20 minutes
• The minimal additional cost of the second pair of gloves is far outweighed by the protection offered against occupational exposure and potential infections

Implementation of Double Gloving

• Healthcare providers should use a slightly larger size for the outer glove to maintain dexterity and comfort
• Indicator glove systems, where the inner glove is colored differently, are particularly useful as they make perforations immediately visible when fluid enters between the layers
• Gloves should be changed at certain intervals during surgery, such as every 90 minutes, to reduce the risk of microperforations 1

Importance of Double Gloving in Cesarean Deliveries

• Cesarean deliveries involve significant blood exposure and the use of sharp instruments in a confined surgical field, making double gloving especially important
• Double gloving can help prevent the transmission of blood-borne pathogens and reduce the risk of surgical site infections
• The use of double gloving is supported by guidelines and recommendations from reputable health organizations, such as the Centers for Disease Control and Prevention (CDC) 1

From the Research

Benefits of Double Gloving for Cesarean Sections

• Reduced risk of exposure to bloodborne pathogens for surgical personnel 2, 3, 4, 5, 6
• Significant reduction in glove perforations, with a 70%-78% risk reduction attributed to double gloving 5
• Protection against damage to the inner glove, preventing subsequent exposure of the surgeon to blood and other body fluids 4
• Decreased frequency of seeing blood on the hand after surgery with double gloving compared to single gloving 3
• Double gloving with an indicator glove system provides added protection and facilitates detection of glove tears or perforations during surgery 3, 6

Key Findings

• The prevalence of glove perforation was 10.67% and 2% in single- and double-inner glove, respectively, with significant difference 2
• Double gloving offers a measure of protection against damage to the inner glove and may prevent subsequent exposure of the surgeon to blood and other body fluids 4
• The use of double gloving significantly reduced perforations to the innermost glove 5
• Evidence supports the use of double gloving and double gloving with an indicator glove system to decrease the risk of percutaneous injury and therefore is an effective barrier to bloodborne pathogen exposure 6