Purpose Glove damage during surgery has many causes– tears, rips, shearing forces, sharp puncture, needle-stick injuries and micro-perforations. Breaches in this aseptic barrier occur frequently, across multiple specialties. These, together with variations in gloving practice, have safety implications for operating room personnel. This meta-synthesis of the best available evidence describes four fundamental principles of surgical gloving practice: glove fit, double gloving, indicator systems, and glove change frequency. It aims to advise on appropriate gloving practice to enhance patient safety. Methodology A 4-arm, parallel, systematic review by a multi-disciplinary team comprising surgeons, nurses and infection control specialists considered all available gloving practice literature from 1980-2022. Studies were assessed for eligibility against pre-defined criteria for the four principles and scored for strength of evidence and risk of bias using the John’s Hopkins, ROBIS 1.2 Systematic Review, ROB-2RCT and Newcastle-Ottowa non RCT assessment tools. Results This review identified 165 articles including 25 high-quality level IA studies. Using the Delphi process ten statements achieved 80% consensus. These, along with strength of the recommendation and evidence rational, will be reported. Where consensus was not achieved the group offered additional expert opinion based on good practice standards, suggesting opportunities for future research. Conclusion Surgical specialty and surgery duration influence the observed rates of glove perforation. A mean glove change time of 60 minutes, or at specific points in procedures is recommended. Clear evidence was identified supporting routine glove change in a bundle of interventions to improve patient clinical outcomes.