Evidence map›Paper›PMID 36048202›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023

Knot tying in arthroplasty and arthroscopy causes lesions to surgical gloves: a potential risk of infection.

Andreas Enz, Annett Klinder, Lucas Bisping, Christoph Lutter, Philipp Warnke, Thomas Tischer, Wolfram Mittelmeier, Robert Lenz

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Andreas EnzOrthopaedic Clinic and Policlinic, University Medicine Rostock, Doberanerstraße 142, 18057, Rostock, Germany. andreas.enz@med.uni-rostock.de.ORCID http://orcid.org/0000-0002-9258-487X
Annett KlinderOrthopaedic Clinic and Policlinic, University Medicine Rostock, Doberanerstraße 142, 18057, Rostock, Germany.
Lucas BispingOrthopaedic Clinic and Policlinic, University Medicine Rostock, Doberanerstraße 142, 18057, Rostock, Germany.
Christoph LutterOrthopaedic Clinic and Policlinic, University Medicine Rostock, Doberanerstraße 142, 18057, Rostock, Germany.
Philipp WarnkeInstitute of Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Rostock, Germany.
Thomas TischerOrthopaedic Clinic and Policlinic, University Medicine Rostock, Doberanerstraße 142, 18057, Rostock, Germany.
Wolfram MittelmeierOrthopaedic Clinic and Policlinic, University Medicine Rostock, Doberanerstraße 142, 18057, Rostock, Germany.
Robert LenzOrthopaedic Clinic and Policlinic, University Medicine Rostock, Doberanerstraße 142, 18057, Rostock, Germany.
Universitätsmedizin Rostock · DEInstitute of Medical Microbiology and Hygiene · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRecent studies have shown that the incidence of glove lesions during arthroscopy is much lower than that during primary and revision arthroplasty. However, the rate of glove damage after knot tying has not yet been systematically recorded. Therefore, the aim of the study was to determine the impact of surgical knot tying on glove integrity. It was hypothesized that knot tying increases the rate of glove damage, especially in arthroscopic surgery, which could be of special relevance in the treatment of rotator cuff tears.

methodsGloves that were changed immediately before suturing and only worn during knot tying were investigated for their integrity by means of water tightening test according to EN455. A total of 234 gloves from 40 total hip arthroplasties (THAs), 42 total knee arthroplasties (TKAs) and 36 rotator cuff repairs (RCRs) were collected. A bacterial pass-through test (BPTT) on glove lesions was performed under simulated sterile surgical conditions for 3 surgeons after a wear duration of 45 min.

resultsGlove damage by knot tying occurred in 25% of THA, 36.6% of TKA and 25% of RCR surgeries. In THA, the pulling hand (PH) was affected in 46.2%, and the main area of damage (15.4%) was detected on the tip of the middle finger; in TKAs the PH was damaged in 75%, and in RCRs the PH was affected in 66.7%, with most of the lesions (20% each) occurring on the tip of the index finger and the ring finger. The BPTT showed Staphylococcus hominis and Bacillus cereus.

conclusionIntraoperative knot tying causes damage to gloves, which is of special relevance for arthroscopic surgery. Whereas knot tying is only partly responsible for glove damage in arthroplasty, the general rate of glove damage in arthroscopic surgery is low without knot tying. The surgical knot tying process must be understood as a possible damaging impact on the glove. Therefore, single gloving is not recommended, which is especially important in arthroscopic surgery, where double gloving is not yet standard. LEVEL OF EVIDENCE: IV.

Indexed as

Arthroplasty, Replacement, HipRotator Cuff InjuriesSurgeonsArthroscopyGloves, SurgicalHumansArthroplastyArthroscopyEN455Glove damageMicroperforationSurgical site infection

Identifiers

PMID36048202
PMCPMC10089991
OpenAlexW4294125577

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.