Clare Heal1, Shampavi Sriharan2, Petra G Buttner3, Deborah Kimber4. 1. College of Medicine and Dentistry, James Cook University, Mackay, QLD, Australia. clare.heal@jcu.edu.au. 2. College of Medicine and Dentistry, James Cook University, Mackay, QLD, Australia. 3. Tropical Health Solutions, Townsville, QLD, Australia. 4. Paul Hopkins Medical Clinic, Mackay, QLD, Australia.
Abstract
OBJECTIVE: To compare the incidence of infection after minor surgery conducted using non-sterile clean boxed gloves with surgery conducted using sterile gloves. DESIGN: Prospective randomised controlled single-centre trial testing for non-inferiority in infection rates. SETTING: Primary care regional centre, Queensland, Australia. PARTICIPANTS: Consecutive patients presenting to participating general practitioners for a minor skin excision, between 30 June 2012 and 28 March 2013, were eligible to participate. INTERVENTION: The use of non-sterile clean boxed gloves was compared with normal treatment using sterile gloves in the control group. MAIN OUTCOME MEASURES: Wound infection, assessed at the time of removal of sutures, and other adverse events. RESULTS:Four hundred and ninety-three consecutive patients presenting for minor skin excisions were randomly allocated to the two treatment groups: non-sterile clean boxed gloves (n = 250) or sterile gloves (n = 243). Four hundred and seventy-eight patients contributed data for analysis (241 non-sterile, 237 sterile gloves). The incidence of infection in the non-sterile gloves group (8.7%; 95% CI, 4.9%-12.6%) was significantly non-inferior compared with the incidence in the control group (9.3%; 95% CI, 7.4%-11.1%). The two-sided 95% CI for the difference in infection rate (- 0.6%) was - 4.0% to 2.9%, and did not reach the predetermined margin of 7% which had been assumed as the non-inferiority limit. RESULTS of the intention-to-treat analysis were confirmed by per-protocol and sensitivity analyses. There were no important adverse effects. CONCLUSION: Our study suggests that in regard to wound infection, non-sterile clean boxed gloves are not inferior to sterile gloves for minor skin excisions in general practice. TRIAL REGISTRATION: ACTRN12612000698875.
RCT Entities:
OBJECTIVE: To compare the incidence of infection after minor surgery conducted using non-sterile clean boxed gloves with surgery conducted using sterile gloves. DESIGN: Prospective randomised controlled single-centre trial testing for non-inferiority in infection rates. SETTING: Primary care regional centre, Queensland, Australia. PARTICIPANTS: Consecutive patients presenting to participating general practitioners for a minor skin excision, between 30 June 2012 and 28 March 2013, were eligible to participate. INTERVENTION: The use of non-sterile clean boxed gloves was compared with normal treatment using sterile gloves in the control group. MAIN OUTCOME MEASURES: Wound infection, assessed at the time of removal of sutures, and other adverse events. RESULTS: Four hundred and ninety-three consecutive patients presenting for minor skin excisions were randomly allocated to the two treatment groups: non-sterile clean boxed gloves (n = 250) or sterile gloves (n = 243). Four hundred and seventy-eight patients contributed data for analysis (241 non-sterile, 237 sterile gloves). The incidence of infection in the non-sterile gloves group (8.7%; 95% CI, 4.9%-12.6%) was significantly non-inferior compared with the incidence in the control group (9.3%; 95% CI, 7.4%-11.1%). The two-sided 95% CI for the difference in infection rate (- 0.6%) was - 4.0% to 2.9%, and did not reach the predetermined margin of 7% which had been assumed as the non-inferiority limit. RESULTS of the intention-to-treat analysis were confirmed by per-protocol and sensitivity analyses. There were no important adverse effects. CONCLUSION: Our study suggests that in regard to wound infection, non-sterile clean boxed gloves are not inferior to sterile gloves for minor skin excisions in general practice. TRIAL REGISTRATION: ACTRN12612000698875.
Authors: C F Heal; D Charles; A Hardy; M Delpachitra; J Banks; M Wohlfahrt; Sabine Saednia; P Buettner Journal: BMJ Open Date: 2016-07-07 Impact factor: 2.692