Free access
Published Online 13 September 2017

Increased safety of surgical glove application: the under/over method

Publication: The Annals of The Royal College of Surgeons of England
Volume 100, Number 4


Surgical gloves are a necessity when performing abdominal surgery not only to protect the patient from bacterial contamination but also to protect the surgeon and surgical assistants from biological fluids. One site for interruption of the barrier between biological fluids in the open abdomen and the surgeon is the interface of the surgical gown and the surgical gloves at the wrist. In the under/over method for double-glove application, the first pair of gloves are positioned under the surgical gown (Figs 1 and 2) and the second pair are positioned over the cuff of the surgical gown and secured with self-adherent wrap (Figs 3 and 4). The under/over method prevents contact of the cuff of the surgical gown with the wrist skin and reduces the possibility of exposure of the surgeon to biological fluids during abdominal surgery.
Figure 1 After the surgeon scrubs and dries their hands, the first pair of surgial gloves (under gloves) are applied and the upper part of the glove advanced to the lower forearm.
Figure 2 The surgical gown is put on and care is taken to advance the cuff of the surgical gown only to the level of the upper palm/lower wrist.
Figure 3 The outer gloves are then put on and the upper portion of the surgical gloves is stretched to the level of the mid-forearm, over the top of the surgical gown.
Figure 4 The outer gloves are secured at the level of the midforearm using a self-adherent wrap. The wrap is applied equally one-and-a-half times around the forearm to the gown and surgical glove.

Information & Authors


Published In

cover image The Annals of The Royal College of Surgeons of England
The Annals of The Royal College of Surgeons of England
Volume 100Number 4April 2018
Pages: 339 - 340
PubMed: 29022816


Published online: 13 September 2017
Published in print: April 2018


Request permissions for this article.



Sugarbaker PH [email protected]
Center for gastrointestinal malignancies, program in peritoneal surface oncology, medstar washington hospital center, Washington, DC, USA


CORRESPONDENCE TO Paul H Sugarbaker, E: [email protected]

Metrics & Citations


Article Metrics



Export citation

Select the format you want to export the citation of this publication.

View Options

View options


View PDF

PDF Plus

View PDF Plus

Get Access

Login Options

Check if you have access through your login credentials or your institution to get full access on this article.

Subscribe and get full access to this article.

Buy Article
Increased safety of surgical glove application: the under/over method Vol.100 • Issue 4 • 24 hours access
GBP 19.99
Add to cart

Restore your content access

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.







Copy the content Link

Share on social media