Chapter 2: Table of Contents
Open gloving is performed when not wearing a gown or when replacing gloves intraoperatively (e.g. to change gloves contaminated by stomach content during gastrotomy prior to abdominal closure) and when a sterile assistant is unavailable to reglove you sterilely. Ask a technician to remove the contaminated gloves without contaminating your gown. Since open gloving must be performed (the gown cuffs are no longer sterile), ask for the gloves to be removed without pulling the gown cuff. If the cuff covers your hands during removal, push your hand through so as to perform open (not closed) gloving. If the sterile glove pack is dropped on a sterile field, open the glove inner package yourself making sure not to contaminate your gown, the gloves or the surgical table. Do not place the glove pack on the instrument table / tray to perform open gloving because handling of the paper with your uncovered hands will contaminate the glove paper and the instrument table. Therefore, when both gloves must be changed, it is best to open the glove pack on a separate table or sterile field to avoid contamination of the surgical instrument table. Alternatively, have an unsterile assistant open the inner package on a non-sterile table ensuring that the inside of the paper package and the gloves are not contaminated. With one hand, pick up the opposite hand glove by the inner portion of the cuff (which will eventually lie against the gown/skin) and slide it onto the fingers and approximately two thirds of the hand being gloved. Do not touch or cover the gown cuff just yet and leave the folded cuff portion down (folded). Slide the partially gloved hand (fingers only) under the folded edge (sterile side) of the opposite glove still sitting in the package. Place the non-gloved fingers of the opposite hand into the glove, and use the partially gloved hand (which is gripping the sterile surface of the folded edge of the cuff) to pull the glove over the hand and wrist and gown cuff if you are gowned. Be careful not to touch any skin with your previously gloved fingers (thumb especially) while unfolding. With the gloved hand (hand gloved second), grip the folded cuff of the partially gloved hand (on the sterile under surface of the fold) and unfold the glove over the hand and wrist or gown cuff to complete gloving. When replacing only one glove such as when replacing a punctured glove during a surgical procedure, proceed as described for open gloving of the second hand.