Surgical glove perforation and maxillofacial trauma: to plate or wire?

The technique of interdental wiring was compared with a small-plate osteosynthesis technique (SPO) in a prospective study of surgical glove perforations acquired during the treatment of mandibular fractures. Using the SPO technique there was a significant reduction in the incidence of skin penetrating injuries in the surgeon (P less than 0.005) and assistant surgeon groups (P less than 0.05). The reduction in the incidence of glove perforation in the assistant surgeon group was very highly significant in the SPO series (P less than 0.001). The reduction in the surgeon group was not significant. No difference was noted in the scrub nurse group. The small-plate osteosynthesis technique has the advantage of reducing the risk of intraoperative cross-infection transmitted by hand contamination or penetrating injury. The recommended precautions for preventing the transmission of blood-borne pathogens are reviewed.