Written by Faith Anderson on December 11, 2012
Nature of Valve-Replacement Surgery
Valve-replacement surgery requires the doctor to use thick sutures and tie more than 100 knots, which puts extra stress on the gloves, the hospital reported, and this is likely what caused the latex gloves to sustain microscopic tears. Hospital officials have called the incident a “very unusual occurrence” probably caused by multiple factors: the nature of the surgical procedure, the tiny tears in the gloves and the surgeon’s skin condition. Although all four patients who required a second operation survived the procedures, the infections have raised questions about what health conditions should prevent a surgeon from operating, and how doctors can get the best protection from surgical gloves. According to Rekha Murthy, medical director of Cedars-Sinai’s epidemiology department, doctors with known infections or open sores aren’t supposed to operate, but there is no nationwide standard regarding skin inflammation. There are also no standards regarding what type of gloves should be used, whether surgeons should double up on gloves, or how many times they should change them during a procedure.
Risk of Hospital-Acquired Infections in the U.S.
Overall, Cedars-Sinai has low rates for hospital-acquired infections compared to state and national averages, but has reportedly not performed as well on other measures involving surgical quality. The hospital learned about the bacteria in June after three patients who underwent valve-replacement procedures showed signs of infection and were eventually diagnosed with endocarditis. After analyzing the bacteria, epidemiologists determined it was an identical strain that must have come from a single source. Soon after, the hospital found the same infection in two more patients, at which point one of the affected patients was treated with antibiotics and the others had new valve-replacement surgeries. All surgeons performing valve replacements at the hospital are now required to change gloves more frequently, and some doctors are wearing double gloves during surgery to avoid a similar situation.