Infection prevention

Surgical double gloving with puncture indication for extra safety

The key to maximum safety is making sure that punctures in surgical gloves can be detected as rapidly as possible. The Biogel® Indicator System's puncture indications are clear1, fast1 and large1 – all important factors to immediate puncture detection and a clear path to safety and reduced risk of infection.

A 2014 Cochrane Review concludes that double gloving reduces the risk of an underglove perforation by 71% compared to single gloving2

The same review concludes that indicator gloves reduce inner-glove perforations by 90% compared to standard double gloves2

Biogel Indicator System detects up to 97% of punctures3

Protection you can see

The Biogel Indicator System is unique in that it offers vividly visible puncture detection in three proven ways:

  • Clear1 – The colour of the inner glove is selected based on colour physics, maximising the sensitivity of the human eye.
  • Fast1 – The gloves are designed to make a puncture visible as fast as possible and to ensure that the regions of indication grow quickly.
  • Large1 – The Biogel puncture indication is large and visible from a distance.

The Biogel PI Micro Indicator system gives significantly more vivid indication than other synthetic double-gloving combinations, making punctures visible quickly.

How the puncture indication system works

The Biogel Indicator System is made up of a dark-coloured underglove and a straw-coloured over glove.

Normally, the over glove blocks out most of the underglove's colour. When fluid gets between the two layers, light passes through the over glove and reveals the underglove.

The proof to back it up

When talking to healthcare professionals about prevention strategies, double gloving is our most important message. You can see why from these important findings in the Cochrane Collaboration's systematic review of double gloving2,4.


The Cochrane review aimed to:

  • determine whether there is a clinically significant difference in using extra gloves for preventing needlestick injuries during surgery
  • evaluate whether double gloving has a negative impact on the healthcare professional's hand skills (dexterity)
  • discover whether additional glove protection reduces the number of underglove perforations


  • Thirty-two randomized controlled trials measuring glove perforations were included. Increasing numbers of glove layers (single, double, triple) were evaluated2.
  • The first review compared single gloving, double gloving and coloured puncture-indicating systems; the second review added four additional gloving methods (glove liner, cloth over gloves, steel-weave over gloves and triple gloves)2
  • The risk was determined through the measurement of perforations and self-reported needlestick injuries. Dexterity was measured via self-reporting and perforation rate2.


Single versus double gloving: 11 percent of gloves perforated using single gloves; 3 percent perforated with double gloving.

Puncture detection proved to be significantly improved for Biogel Puncture Indication System gloves.

The evidence confirms that double gloving provides better protection against accidental perforations and needlestick injuries and does not significantly influence dexterity when measured as the number of outer glove perforations2,4.



  1. MHC on file Report no. 887.
  2. Mischke C, Verbeek JH, Saarto A, Lavoie MC, PahwaM, Ijaz S. Gloves, extra gloves or special types of gloves for preventing percutaneous exposure injuries in healthcare personnel. Cochrane Database of Systematic Reviews 2014, Issue
  3. Art. No.: CD009573. DOI: 10.1002/14651858.CD009573.pub2.
  4. Wigmore SJ & Rainey JB, BJS 1994: 81: 1480.
  5. Tanner J, Parkinson H. Double gloving to reduce surgical cross-infection. Cochrane Database of Systematic Reviews 2006, Issue 3. Art No.: CD003087. DOI: 10.1002/14651858.CD003087.pub2 (second review 2000-2005).
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