Putting on surgical gloves correctly means keeping the outer surface sterile from the moment you open the package until the procedure is done. The technique is straightforward once you learn it, but small mistakes, like touching the outside of a glove with a bare finger, can contaminate the sterile field and defeat the purpose entirely. Here’s how to do it right.
Prepare Your Hands First
Before you touch the glove packaging, remove all rings, watches, and bracelets. Artificial nails are not allowed. If your hands are visibly dirty, wash them with plain soap first, and use a nail cleaner under running water to clear debris from beneath your fingernails.
Next, perform a surgical hand scrub using either an antimicrobial soap or an alcohol-based hand rub. If you’re using soap, scrub your hands and forearms for 2 to 5 minutes (follow the product’s label). Longer scrubs of 10 minutes offer no additional benefit. If you’re using an alcohol-based rub, apply it to completely dry hands and keep your skin wet with the product throughout the process. Do not use both soap and alcohol rub back to back. Whichever method you choose, let your hands dry thoroughly before opening the glove package. Wet hands make gloving harder and can compromise the glove’s grip and sterility.
Choose the Right Size
Surgical gloves are sized by number, and the fit matters more than it does with exam gloves. A glove that’s too loose reduces your tactile sensitivity; one that’s too tight fatigues your hands and tears more easily. To find your size, measure the circumference of your dominant hand around the widest part of the palm (excluding the thumb) with a tape measure. The measurement in inches roughly equals your glove size: 7 inches corresponds to a size 7, 8 inches to a size 8, and so on. Sizes typically range from 6 (extra small) through 9 or 10 (large to extra large).
The Open Gloving Technique
Open gloving is the standard method when you’re not wearing a sterile surgical gown. It relies on one simple rule: bare skin only touches the inside of the glove, and the gloved hand only touches the outside.
Open the outer packaging on a clean, flat surface, then peel open the inner sterile wrapper without touching the gloves themselves. You’ll see the gloves laid out with the cuffs folded back, palms facing up, and the right glove on the right side.
First Glove
Pick up the first glove (usually your dominant hand) by pinching the folded cuff on its inner surface with your opposite hand. Slide your hand in, wiggling your fingers into position. Don’t try to unfold the cuff yet. At this point, only the inside of the glove has been touched by bare skin, so the outside remains sterile. If the fingers aren’t seated perfectly, leave them for now.
Second Glove
Slide the fingers of your now-gloved hand under the folded cuff of the second glove, touching only the outer (sterile) surface. Lift the glove up and away from the wrapper, then slide your bare hand in. Because the gloved fingers are only contacting the sterile exterior of the second glove, the sterile field stays intact. Pull the cuff up and over your wrist.
Now go back to the first glove. Slip the fingers of your second gloved hand under the folded cuff of the first glove, again only touching the sterile outside, and roll the cuff up over your wrist. Adjust the fit of both gloves by gently pressing between the fingers and smoothing the material over your palms. From this point forward, keep your gloved hands above waist level and away from any non-sterile surface.
Closed Gloving for Gowned Procedures
If you’re wearing a sterile surgical gown, the closed technique adds an extra layer of protection. Instead of pushing your hands all the way through the gown’s sleeves, keep your fingertips inside the cuffs. Lay the glove palm-down on the sleeve of the corresponding hand, with the glove’s fingers pointing toward your elbow. Use your sleeve-covered opposite hand to grasp the glove cuff and fold it over the gown’s cuff, then push your hand through both the gown sleeve and glove simultaneously. Repeat on the other side. This method ensures bare skin never contacts the outside of the glove or gown at any point.
Common Mistakes That Break Sterility
The most frequent error is touching the outer surface of a glove with a bare finger during the first glove. It happens quickly, often when you’re rushing to seat your fingers. If it happens, discard the glove and start with a fresh pair. Touching any non-sterile surface once both gloves are on, even your own face or the edge of the table, also contaminates them. Glove perforations are another risk: tiny punctures can allow bacteria from your skin to pass through to the sterile side. You often won’t feel a perforation happen, which is one reason double gloving exists.
When Double Gloving Makes Sense
Double gloving means wearing two pairs of surgical gloves, one over the other. It’s recommended for any procedure with a higher risk of sharp injury or blood exposure. A large meta-analysis found that hand contamination rates dropped from 2.4% with single gloves to 0.7% with double gloves. Inner glove perforation rates were about 80% lower when a second glove was worn over the top. Indicator gloves, which are a colored inner pair that shows a visible color change at the puncture site, make it much easier to detect perforations during surgery (detection rates of 58% for double gloves versus 34% for single gloves). If you double glove, the inner pair is typically a half size smaller and the outer pair a half size larger than your standard size, so the fit remains comfortable.
Glove Material Options
Latex remains the gold standard for surgical gloving. It offers the best virus protection, excellent elasticity, and the highest tactile sensitivity. Polyisoprene is the closest latex-free alternative, matching latex in comfort and stretch, and is the go-to for anyone with a latex allergy. Nitrile gloves provide superior chemical resistance and puncture strength but sacrifice some elasticity and finger sensitivity. Some manufacturers blend nitrile with a small amount of latex to improve the feel. Your choice depends on allergy status, the type of procedure, and personal preference for fit.
How to Remove Gloves Safely
Removal follows a “glove touches glove, skin touches skin” principle designed to keep contaminated surfaces away from your hands. Pinch the outside of one glove at the wrist and peel it off, turning it inside out as you pull it away from your body. Hold the removed glove in your still-gloved hand. Then slide your bare fingers inside the wrist of the remaining glove, peel it off inside out, and let the first glove end up bundled inside the second. Dispose of both immediately and wash your hands. Gloves are not a substitute for hand hygiene; bacteria can migrate through microscopic defects or accumulate under the glove during a procedure.