Intervention Review

Double gloving to reduce surgical cross-infection

  1. Judith Tanner1,*,
  2. Hazel Parkinson2

Editorial Group: Cochrane Wounds Group

Published Online: 19 JUL 2006

Assessed as up-to-date: 28 JUL 2009

DOI: 10.1002/14651858.CD003087.pub2

How to Cite

Tanner J, Parkinson H. Double gloving to reduce surgical cross-infection. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD003087. DOI: 10.1002/14651858.CD003087.pub2.

Author Information

  1. 1

    De Montfort University and University Hospitals Leicester, Leicester, UK

  2. 2

    St James's University Hospital, Geoffrey Giles Theatres, Leeds, UK

*Judith Tanner, De Montfort University and University Hospitals Leicester, Charles Frears Campus, 266 London Road, Leicester, LE2 1RQ, UK.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 19 JUL 2006




  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laienverständliche Zusammenfassung


The invasive nature of surgery, with its increased exposure to blood, means that during surgery there is a high risk of transfer of pathogens. Pathogens can be transferred through contact between surgical patients and the surgical team, resulting in post-operative or blood borne infections in patients or blood borne infections in the surgical team. Both patients and the surgical team need to be protected from this risk. This risk can be reduced by implementing protective barriers such as wearing surgical gloves. Wearing two pairs of surgical gloves, triple gloves, glove liners or cloth outer gloves, as opposed to one pair, is considered to provide an additional barrier and further reduce the risk of contamination.


The primary objective of this review was to determine if additional glove protection reduces the number of surgical site or blood borne infections in patients or the surgical team. The secondary objective was to determine if additional glove protection reduces the number of perforations to the innermost pair of surgical gloves. The innermost gloves (next to skin) compared with the outermost gloves are considered to be the last barrier between the patient and the surgical team.

Search methods

For this second update we searched the Wounds Group Specialised Register (June 2009), the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 2, 2009), Ovid MEDLINE (1950 to May Week 5 2009), Ovid EMBASE (1980 to 2009 Week 22 ) and EBSCO CINAHL (1982 to May Week 4 2009).

Selection criteria

Randomised controlled trials involving: single gloving, double gloving, triple gloving, glove liners, knitted outer gloves, steel weave outer gloves and perforation indicator systems.

Data collection and analysis

Both authors independently assessed the relevance and quality of each trial. Data was extracted by one author and cross checked for accuracy by the second author.

Main results

Two trials were found which addressed the primary outcome, namely, surgical site infections in patients. Both trials reported no infections.

Thirty one randomised controlled trials measuring glove perforations were identified and included in the review.

Fourteen trials of double gloving (wearing two pairs of surgical latex gloves) were pooled and showed that there were significantly more perforations to the single glove than the innermost of the double gloves (OR 4.10, 95% CI 3.30 to 5.09).

Eight trials of indicator gloves (coloured latex gloves worn underneath latex gloves to more rapidly alert the team to perforations) showed that significantly fewer perforations were detected with single gloves compared with indicator gloves (OR 0.10, 95% CI 0.06 to 0.16) or with standard double glove compared with indicator gloves (OR 0.08, 95% CI 0.04 to 0.17).

Two trials of glove liners (a glove knitted with cloth or polymers worn between two pairs of latex gloves)(OR 26.36, 95% CI 7.91 to 87.82), three trials of knitted gloves (knitted glove worn on top of latex surgical gloves)(OR 5.76, 95% CI 3.25 to 10.20) and one trial of triple gloving (three pairs of latex surgical gloves)(OR 69.41, 95% CI 3.89 to 1239.18) all compared with standard double gloves, showed there were significantly more perforations to the innermost glove of a standard double glove in all comparisons.

Authors' conclusions

There is no direct evidence that additional glove protection worn by the surgical team reduces surgical site infections in patients, however the review has insufficient power for this outcome.

The addition of a second pair of surgical gloves significantly reduces perforations to innermost gloves. Triple gloving, knitted outer gloves and glove liners also significantly reduce perforations to the innermost glove. Perforation indicator systems results in significantly more innermost glove perforations being detected during surgery.


Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laienverständliche Zusammenfassung

Double gloving to reduce surgical cross-infection

Surgical operations are undertaken within a clean environment and with members of the surgical team wearing sterile gloves. Sterile surgical gloves aim to protect the patient from contamination with bacteria from members of the surgical team and protect the surgical team from the body fluids of the patient. Double-gloving (wearing two sets of gloves) is becoming more common, especially for surgery where sharp surfaces are formed (such as orthopaedic or dental surgery). The review found that a second pair of gloves does protect the inner pair, without apparently affecting surgical performance. A glove liner between the two pairs of gloves reduces breaks to the inner glove even further, and extra-thick gloves seem to be as good as two pairs.



  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laienverständliche Zusammenfassung







今回の2回目の改定のために、Wounds Group Specialised Register(2009年6月)、Cochrane Central Register of Controlled Trials(CENTRAL)(2009年第2号)、Ovid MEDLINE(1950年~2009年5月第5週)、Ovid EMBASE(1980年~2009年第22週)およびEBSCO CINAHL(1982年~2009年5月第4週)を検索した。






主要アウトカム、すなわち患者の手術部位の感染を取り扱った2件の試験を見いだした。両試験から感染は報告されていなかった。手袋穿孔を評価していた31件のランダム化比較試験を同定し、本レビューに含めた。二重手袋に関する14件の試験(ラテックス手術用手袋の二重装着)を統合した結果、二重手袋の内側の手袋に比べ、一重手袋では穿孔が有意に多いことが示された(OR4.10、95%CI 3.30~5.09)。インジケータ手袋(チームに穿孔を迅速に知らせるためにラテックス手袋の内側に装着する着色ラテックス手袋)に関する8件の試験では、インジケータ手袋に比較して一重手袋(OR0.10、95%CI0.06~0.16)またはインジケータ手袋に比較して標準的な二重手袋で(OR0.08、95%CI 0.04~0.17)検知された穿孔が有意に少ないことが示された。手袋ライナー(2枚のラテックス手袋の間に装着する布またはポリマーで編んだ手袋)に関する2件の試験(OR 26.36、95%CI 7.91~87.82)、編み手袋(ラテックス手術用手袋の一番上に装着する編み手袋)に関する3件の試験(OR5.76、95%CI 3.25~10.20)、三重手袋(ラテックス手術用手袋を三重に装着)(OR 69.41、95%CI 3.89~1239.18)に関する1件の試験はすべて、標準的二重手袋と比較して、すべての比較において標準的二重手袋の最も内側の手袋で穿孔が有意に多いことが示された。




監  訳: 林 啓一,2010.2.10

実施組織: 厚生労働省委託事業によりMindsが実施した。

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  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laienverständliche Zusammenfassung







我們搜尋了the Wounds Group Specialised Register (2006年1月) 以及the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2005年第4期), 我們同時也聯繫了手套製造商以及專業團體。


探討以下主題的隨機對照試驗 (Randomised controlled trials;RCTs) 將被納入:單層手套、雙層手套、三層手套、手套內襯、外層針織手套、外層鋼製手套以及刺穿警示系統。




發現有2項試驗評估了主要的指標,亦即患者手術部位的感染,這兩項試驗都沒有發現有感染的形況發生。總有31項評估手套刺穿的隨機對照試驗,被納入本份文獻回顧中。我們把14項有關雙層手套 (戴兩層外科乳膠手套) 的試驗結果整合起來,發現單層手套發生刺穿的機會,明顯比雙層手套的內層被刺破的機會來得高 (OR 4.10, 95% CI 3.30 to 5.09) 。8項有關警示型手套 (在乳膠手套底下再加上有顏色的乳膠手套,可以讓醫護團隊更快警覺到手套被刺破了) 的試驗顯示,比起使用警示型手套,如果只戴1層手套或使用標準規格的雙層手套,則明顯較不容易發現到手套已被刺破 (OR 0.08, 95% CI 0.04 to 0.17) 。在2項探討手套內襯 (在2副乳膠手套中間縫入布料或聚合物) (OR 26.36, 95% CI 7.91 to 87.82) 、3項針織手套 (在乳膠手套的頂端套上針織手套) (OR 5.76, 95% CI 3.25 to 10.20) 、1項3層手套 (戴3副乳膠手套) (OR 69.41, 95% CI 3.89 to 1239.18) 的試驗中,全部都發現標準規格的雙層手套明顯比這些手套更容易會發生最內層被刺破的狀況。





此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。




Laienverständliche Zusammenfassung

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. アブストラクト
  5. 摘要
  6. Laienverständliche Zusammenfassung

Tragen von zwei Paar Handschuhe zur Verminderung von operations-bedingten Kreuzinfektionen

Chirurgische Operationen werden in einem sauberen Umfeld durchgeführt und das behandelnde Team trägt sterile Handschuhe. Diese Handschuhe sollen die Patienten vor einer Kontaminierung mit Bakterien und das behandelnde Team vor den Körperflüssigkeiten des Patienten schützen. Das Tragen von zwei Paar Handschuhen übereinander wird üblicher, insbesondere bei Operationen in den scharfe Kanten entstehen (wie zum Beispiel bei orthopädischen Operationen oder Zahneingriffen). Diese Übersichtsarbeit zeigt, dass ein zweites Paar Handschuhe den inneren Handschuh schützt, ohne dabei die chirurgischen Fähigkeiten zu beeinträchtigen. Ein Handschuhfutter zwischen den beiden Handschuhen reduziert die Zahl der Risse noch mehr und besonders dicke Handschuhe scheinen so gut zu sein wie zwei Paar Handschuhe.

Anmerkungen zur Übersetzung

Koordination durch Cochrane Schweiz.