Detecting Surgical Glove Breaches: Evaluation of Double Glove Indicator System Performance Using an In Vitro Glove Perforation Method

Background: Surgical glove breaches may compromise the aseptic barrier and pose risks to surgical staff. Double gloving with an indicator system improves breach detection compared with similar colored double gloves or single gloving. This study evaluates the performance of market-leading indicator gloves for breach detection. Methods: Liquid was introduced between layers of breach indicating polyisoprene double gloves (Brands A [six styles], B [three styles], and C [two styles]). Indication area was measured using a calibrated camera at two time points (immediate = 9.8 sec; final = 49 sec). Performance differences between styles and brands were analyzed using Games–Howell and Mood’s tests (95% confidence interval). Results: Brand A had a larger and faster immediate median indication area (544 mm 2 ; 55.5 mm 2 /sec; p < 0.05), compared with Brand B (61 mm 2 ; 6.2 mm 2 /sec) and Brand C (115 mm 2 ; 11.7 mm 2 /sec); this was 9.0 and 4.7 times faster than Brands B and C, respectively. Brand A also displayed a larger final median indication area (597 mm 2 ; p < 0.05), compared with Brands B (124 mm 2 ) and C (314 mm 2 ), with a 4.8 and 1.9 times larger area, respectively. Brand A immediately reached 91% of its final indication area compared with only 49% and 37% for Brands B and C, respectively. Conclusions: Indicator glove performance influences breach visualization. Brand A gloves, which have unique surface characteristics, displayed the fastest and largest breach indication among the brands tested. Faster and larger breach indication enables rapid detection and response, protecting the aseptic barrier between the wearer and patient.