Glove Perforation in Arthroscopic Anterior Cruciate Ligament Reconstruction: A Silent Culprit of Infection

Year 2025, Volume: 1 Issue: 1, 1 - 4, 08.09.2025

Ahmet Keskin

Abstract

With the growing popularity of sports, the number of arthroscopic anterior cruciate ligament (ACL) reconstructions has steadily increased. Although postoperative infection rates after arthroscopy are relatively low (0.28–1.0%), they can cause significant complications, particularly in young and active patients. One overlooked factor is glove perforation, which may contaminate the surgical field and allow infection to pass between the surgical team and the patient. This study aimed to determine the incidence of glove perforation during arthroscopic ACL reconstruction.
A prospective single-center study was conducted between August 2 and October 1, 2024. Gloves used by the primary surgeon, assistant surgeon, and scrub nurse were collected after ACL reconstruction procedures. All operations employed the anatomical single bundle technique with hamstring tendons. Perforations were detected by filling the gloves with water mixed with food coloring and applying pressure to reveal leaks.
In total, 43 surgeries were evaluated. Glove perforation was identified in 44.2% of procedures. The second surgeon had the highest perforation rate (68.7%), while scrub nurses demonstrated the greatest overall incidence (52.6%). The most frequent stage for glove perforation occurred during the opening of bone tunnels (47.4%).
In conclusion, glove perforation is common in arthroscopic ACL reconstruction, largely due to the use of sharp surgical instruments. Routine glove changes after 90 minutes and careful handling of penetrating tools are recommended to minimize infection risks and prevent septic arthritis.

Keywords

Septic Arthritis , Anterior Cruciate Ligament , Glove Perfotation

Artroskopik Ön Çapraz Bağ Rekonstrüksiyonunda Eldiven Perforasyonu: Enfeksiyonun Gizli Nedeni

Abstract

Sporun giderek artan popülaritesi ile birlikte artroskopik ön çapraz bağ (ACL) rekonstrüksiyonlarının sıklığı da artmaktadır. Enfeksiyon oranları düşük olmakla birlikte (%0,28–1,0), bu komplikasyon genç ve aktif hastalarda önemli sosyal ve ekonomik sorunlara yol açabilmektedir. Eldiven perforasyonu, cerrahi alanın kontaminasyonuna ve enfeksiyonun hem hasta hem de cerrahi ekip arasında taşınmasına neden olabilecek, sıklıkla göz ardı edilen bir risk faktörüdür. Bu çalışmada artroskopik ACL rekonstrüksiyonu sırasında cerrahi ekipte eldiven perforasyonu insidansı araştırılmıştır.
Çalışma, 2 Ağustos–1 Ekim 2024 tarihleri arasında tek merkezde prospektif olarak yürütülmüştür. Primer cerrah, asistan cerrah ve steril hemşirenin ameliyat boyunca kullandıkları eldivenler incelenmiştir. Perforasyonlar, eldivenlerin su ve gıda boyası ile doldurulup basınç uygulanması ile tespit edilmiştir. Toplam 43 ameliyat değerlendirilmiş, bunların %44,2’sinde eldiven perforasyonu saptanmıştır. En yüksek perforasyon oranı ikinci cerrahta (%68,7) gözlenmiş, perforasyonların en sık görüldüğü aşama kemik tünellerinin açılması olmuştur (%47,4). Ayrıca, steril hemşire %52,6 ile en yüksek perforasyon oranına sahiptir.
Sonuç olarak, artroskopik ACL rekonstrüksiyonları sırasında eldiven perforasyonu önemli bir risk oluşturmaktadır. Penetran cerrahi aletlerin dikkatli kullanımı ve ameliyatın 90. dakikasında eldivenlerin rutin olarak değiştirilmesi enfeksiyon riskini azaltmada etkili olabilir.

Keywords

Ön Çapraz Bağ , Septik Artrit , Eldiven Delinme

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