***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Surgeons have the highest risk of contact with patients ' blood and body fluids , and breaches in gloving material may expose operating room staff to risk of infections . This prospect i ve r and omised study was done to assess the effectiveness of the practice of double gloving compared with single gloving in decreasing finger contamination during surgery . In 66 consecutive surgical procedures studied , preoperative skin abrasions were detected on the h and s of 17.4 % of the surgeons . In the double gloving pattern , 32 glove perforations were observed , of which 22 were in the outer glove and 10 in the inner glove . Only four outer glove perforations had matching inner glove perforations , thus indicating that in 82 % of cases when the outer glove is perforated the inner glove will protect the surgeon 's h and from contamination . The presence of visible skin contamination was also higher in perforation with the single gloving pattern ( 42.1 % ) than with the double gloving pattern ( 22.7 % ) . An overwhelming majority of glove perforations ( 83.3 % ) went unnoticed . Double gloving  was accepted by the majority of surgeons , especially with repeated use . It is recommended that double gloves are used routinely in all surgical procedures in view of the significantly higher protection it provides OBJECTIVE : To compare the rate of glove perforation as a proxy for needlestick injuries between blunt and sharp needles used during cesarean-delivery closure and to survey physician satisfaction with blunt needles . METHODS : Patients requiring cesarean delivery were assigned r and omly to receive closure with either blunt ( study group ) or sharp needles ( control group ) . Patient demographics , operator experience , and other clinical variables were collected . Physicians reported any percutaneous injuries and were surveyed regarding satisfaction with the assigned needles . Glove perforation was determined using a vali date d water-test method . Differences between patient groups were tested using & khgr;2 and Fisher exact test for categorical variables and Student t-test or Wilcoxon rank-sum test for continuous variables . RESULTS : There were 194 patients enrolled in the trial : 97 in the control group and 97 in the study group . There were no statistical differences between groups in patient demographics . There were no differences between groups in clinical variables , type of cesarean delivery , or experience level of the surgeon . There was a significant reduction in total glove perforation rate for the primary surgeon with blunt needles ( 7.2 % ) compared with sharp needles ( 17.5 % ) ( relative risk [ RR ] 0.66 , 95 % confidence interval [ CI ] 0.49–0.89 ) as well as for the assistant surgeon ( RR 0.54 , 95 % CI 0.41–0.71 ) . There was poor correlation between reported perforations and those detected by water test ( R2=0.3 ) . Physicians reported that they were not as satisfied with blunt needles compared with sharp needles ( P=.001 ) . CONCLUSION : There was a significant decrease in the rate of glove perforation for surgeons and assistants performing cesarean-delivery closure with blunt needles . Assistant surgeons had the greatest reduction in glove perforations . However , physicians reported decreased satisfaction performing the surgery with blunt needles . CLINICAL TRIAL REGISTRATION : Clinical Trials.gov , www . clinical trials.gov , NCT00844636 LEVEL OF EVIDENCE : The double gloving indicator underglove system ( IUS ) is based on a colored detection of the outer glove perforation . Our objective was to determine the IUS efficiency to detect outer glove perforations and to reduce the risks of blood and body fluids exposure , warning the surgeon before the breach of the surgeon – patient barrier ( SPB ) . A series of 100 visceral surgical procedures were r and omly assigned to either double ( IUS ) or single gloving . The noticed glove perforations ( using the water test method ) and the  IUS efficiency were analyzed in 99 procedures . In 49 single-gloving procedures , 19 perforations were noticed : one was immediately perceived ( perceived accidental exposure , PAE ) ; 3 were discovered as the gloves were being removed , and 15 were undetected before the water test ( unperceived prolonged contact , UPC ) . In 50 double-gloving procedures ( IUS ) , 16 perforations were noticed , all of them involving only the outer glove : the IUS allowed immediate detection of 3 perforations without any blood exposure ; 13 other perforations went undetected but without any UPC . In conjunction with the protective quality of double gloving , the IUS allows detection of significant breaches of the outer glove before the breach of the SPB Glove perforation frequently occurs during the course of surgical procedures , introducing risks for both surgeons and patients . The aim of this study was to compare the use of blunt tapered and “ sharp ” needles during abdominal wall closure with respect to the incidence of glove perforation and the convenience of needle h and ling . A series of 200 patients undergoing laparotomy in a 6-month period for general surgical disorders were r and omized to two groups ; in one , the abdominal fascia was closed with a blunt tapered needle ; in the other , a sharp needle was used . The main outcome measures were glove perforation and convenience of h and ling the needle .  Univariate and multivariate analyses were performed . In all , 56 glove perforations occurred during 40 ( 20 % ) surgical procedures .Perforation rates differed significantly : 12 % for the blunt ( n = 100 ) tapered needle and 28 % ( n = 100 ) for the sharp needle ( p = 0.003 ) . Only in 12 cases ( 21 % ) was the glove perforation detected at surgery . The type of needle ( odds ratio 0.35 , p = 0.006 ) and time taken to close the fascia ( odds ratio 1.001 , p = 0.05 ) significantly affected the risk of glove perforation . At multivariate logistic regression analysis the type of needle ( odds ratio 0.23 , p = 0.004 ) and the visual analog linear scale ( VAS ) for ease of needle h and ling ( odds ratio 1.18 , p = 0.019 ) were important predictive factors for glove perforation . With the blunt tapered needle , the VAS was significantly ( p = 0.0003 ) higher at primary laparotomy than at relaparotomy . Use of the blunt tapered needle reduces the incidence of glove perforation . Laborious closure predicts glove perforation .  Blunt tapered needles are less convenient in closing a scarred abdominal fascia To assess the value of double‐gloving in gynaecological surgery OBJECTIVE To investigate the incidence of glove perforations during various types of gastrointestinal surgery , to record the incidence of blood contamination of the h and s , and to evaluate the protective effect of double gloving . DESIGN R and omised prospect i ve trial . SETTING University hospital , Denmark . MATERIAL 566 pairs of gloves tested on surgeons , assistants , and scrub nurses . INTERVENTIONS The participants were allocated to wear either single gloves or Indicator double gloves . MAIN OUTCOME MEASURES The number of glove perforations and the incidence of blood contamination of the h and s. RESULTS The perforation rate in single gloves was 53/306 ( 17 % ) , and that of both outer and inner Indicator gloves at corresponding sites was 6/260 ( 2 % ) ( p < 0.0001 ) . Double gloving reduced the rate of blood contamination of the h and s among surgeons from 15/115 ( 13 % ) to 2/98 ( 2 % ) ( p < 0.005 ) . CONCLUSION The use of Indicator double gloves is recommended in gastrointestinal surgery because of the appreciable protection against blood contamination that they offer BACKGROUND There is increased tendency towards double-gloving by general surgeons in our practice , due probably to awareness of the risk of contamination with blood or other body fluids during surgery . The aim of the study was to compare the relative frequency of glove puncture in single-glove versus double glove sets in general surgical procedures , and to determine if duration of surgery affects perforation rate . METHOD Surgeons at r and om do single or double gloves at their discretion , for general surgical procedures . All the gloves used by the surgeons were assessed immediately after surgery for perforation . RESULTS A total of 1120 gloves were tested , of which 880 were double-glove sets and 240 single-glove sets . There was no significant difference in the overall perforation rate between single and double glove sets ( 18.3 % versus 20 % ) . However , only 2.3 % had perforations in both the outer and inner gloves in the double glove group . Therefore , there was significantly greater risk for blood-skin exposure in the single glove sets ( p < 0.01 ) . The perforation rate was also significantly greater during procedures lasting an hour or more compared to those lasting less than an hour ( p < 0.01 ) . CONCLUSION Double-gloving reduces the risk of blood-skin contamination in all general surgical procedures , and especially so in procedures lasting an hour or more OBJECTIVE The purpose of this study was to compare the relative frequency of glove perforations in double-glove versus single-glove sets . STUDY DESIGN In this prospect i ve cohort study , surgeons  single or double-gloved for pelvic surgery procedures at their own discretion . Gloves were collected at the end of each procedure and evaluated for perforations . RESULTS We tested 1000 sets of gloves : 675  double-glove sets and 325  single-glove sets . The highest rate of perforation ( 19 % ) occurred during major gynecologic procedures . Surgical nurses were the most likely member of the surgical team to sustain a glove injury . There was no significant difference in the total perforation rate between double and single glove sets ( 10 % vs 11 % ) . However , there was a significantly greater potential for blood-skin exposure in the single glove sets . Eleven percent of single glove sets contained a perforation , whereas only 2 % of double glove sets contained a corresponding defect in the inner and outer gloves ( P < .01 ) . CONCLUSION Surgeons should double-glove for all pelvic surgery procedures PURPOSE This study was conducted to comparatively evaluate , in a prospect i ve and r and omized manner , 2 techniques for providing double-gloving protection during arch bar placement for intermaxillary fixation . MATERIAL S AND METHODS A total of 42 consecutive patients in whom application of an Erich bar was indicated for intermaxillary fixation were equally divided into 2 groups . In group 1 , 2 sterile surgical gloves were used ; in group 2 , a nonsterile disposable inner glove was used under a sterile surgical glove .  Wilcoxon , Mann-Whitney , Kruskal-Wallis , and binomial statistical tests were used to analyze the findings . RESULTS A total of 103 perforations were found in the outer gloves ( 47 in group 1 and 56 in group 2 ) , along with 5 perforations in inner gloves in both groups ( alpha = .01 ) . No significant statistical difference was found between groups in terms of inner glove perforations ( alpha = .05 ) . The nondominant h and presented with 70.9 % of the perforations , statistically significant to 1 % . CONCLUSIONS Both double-gloving techniques were found to provide effective clinician protection . The use of a nonsterile disposable glove under the surgical glove is possible for less-invasive procedures , offering the same safety as using 2 sterile surgical gloves while decreasing operational costs . This method does not eliminate the need to change gloves when a perforation is suspected or noted during the surgery , however BACKGROUND In surgery , intact gloves protect the surgeon from bloodborne pathogens and the surgical wound from microorganisms on the skin of the surgeon . However , glove perforation is very common , and puncture rates as high as 61 % are published in the literature . One objective of this study was to compare puncture rates between a unique double-gloving puncture indication system and single-use gloves , and another was to determine the extent to which glove perforations remain undetected during surgery . METHODS The study material comprised all gloves used in surgical operations at our hospital for a period of 2 months . The analysis was made by the glove type in a prospect i ve and r and omized manner . Gloves were tested immediately after the surgical procedure using the approved st and ardized water-leak method for 2 minutes to detect any holes . The gloves used in this study were either a double-gloving puncture indication system or the st and ard glove used at our hospital . RESULTS In 885 operations altogether , 2,462 gloves were tested ; 1,020 single gloves , 1,148 double-glove  systems , and 294 combination gloves were studied . The overall perforation rate was 192 out of 2,462 gloves ( 7.80 % ) , and 162 out of 885 operations ( 18.3 % ) . The detection of perforation during surgery was 28 out of 76 ( 36.84 % ) with single gloves , 77 out of 89 with the double-gloving system ( 86.52 % ) , and 9 out of 27 with combination gloves ( 33.33 % ; P < 0. 
    Output:
    
In conclusion , this review suggests that both safeguard interventions and educational training programs are effective in reducing the risk of having needlestick injuries .