Surgical and Exam Gloves

Avoid latex gloves as much as possible.

While there are several latex alternatives for disposable gloves, the advantages and disadvantages of each mean it is important to choose the right glove for the situation. Gloves are classed as Exam Grade or General Purpose. Exam gloves are regulated by the FDA, general purpose gloves are not. Exam gloves are regulated by the U.S. Food and Drug Administration’s (FDA) Center for Devices and Radiological Health and tested using standards provided by ASTM International (www.astm.org) in the United States and in Europe by the Personal Protective Equipment Directive for the European Community (ec.europa.eu).

The following considerations should be taken into account when selecting medical gloves:

1. Allergies: will the gloves cause an allergic reaction in staff or patients.

2. Blood borne pathogen barrier protection: medical gloves should provide protection in compliance with ASTM F 1671 (ASTM F1671 - 07 Standard Test Method for Resistance of Materials Used in Protective Clothing to Penetration by Blood-Borne Pathogens Using Phi-X174 Bacteriophage Penetration as a Test System, information provided with glove manufacturer.) Additionally, it is recommended that gloves comply with ASTM F1671-97a (Resistance of Materials to Penetration by Blood-Borne Pathogens) to ensure barrier protection against certain viral elements.

3. Chemical barrier protection: medical gloves should provide protection against chemicals including, but not limited to, chemotherapy drugs, and sterilants. This protection is measured using ASTM F 739 (Standard Test Method for Resistance of Protective Clothing Materials to Permeation by Liquids or Gases Under Conditions of Continuous Contact) and ASTM F 1383-96 (Standard Test Method for Resistance of Protective Clothing Materials to Permeation by Liquids or Gases Under Conditions of Intermittent Contact).

4. Elasticity and Tensile Strength: how far will a glove stretch without breaking and how much force it takes.

5. Cut resistance

6. Abrasion resistance

7. Tear resistance

8. Puncture resistance

9. Dexterity

10. Contamination: powdered gloves can lead to complications in surgical patients and increase allergy risk. Airborne powder can carry high levels of both latex and bacteria, increasing risk for infection and latex allergy reactions. Other contaminants, like silicone, can leave residue behind, either airborne or through direct contact.

Denise M. Korniewicz, PhD, RN, FAAN, Professor and Senior Associate Dean for Research at the University of Miami School of Nursing and Health Studies and School of Medicine, Department of Epidemiology has published the following guidelines for comparative medical gloves (Dr. Denise M. Korniewicz. Advantages and Disadvantages of Non-latex Surgical Gloves.):

Table 1: Selection Guide for Gloves Used in Healthcare Settings

Barrier Protection

Strength & Durability

Puncture Resistance

Fit & Comfort

Elasticity

Allergenicity

Latex

Long-standing barrier qualities

Strong, natural rubber is durable

Has re-seal qualities

Provides comfortable fit

Natural ability due to elastic quality rubber

Contains protein & chemical allergens low powder is preferred

Neoprene (Chloroprene)

Good but tear resistance is marginal

Strong

Has some puncture resistant qualities

Provides a good fit, has some elastic ability that enhances fit

Close to latex and allows for flexibility

Contains no latex proteins but has some accelerator chemicals

Nitrile

Resistant to punctures & tears, flexes and does not develop holes

Strong has puncture resistant qualities

Has puncture resistant qualities

Slightly tighter fit

Less than latex over time tends to shape to wearer's hand

Contains no proteins but contains some accelerator chemicals

Vinyl

Easily breaks during use, baggy

Weak, breaks easily & punctures easily in use

Punctures with sharps

Fit limited baggy

Dexterity compromised

Contains no proteins but chemical accelerators

Polyurethane

Durable and high puncture resistance

Excellent tear puncture and abrasion resistance

Superior to latex for puncture resistance; mimics nitrile in performance

Good comfort and fit; has latex-like qualities

Elasticity is apparent

Contains no latex proteins & no chemical accelerators

Copolymer (Block Polymers)

Good resistance to tears

Stronger than vinyl; puncture resistance is fair

Easy to puncture

Latex like fit and comfortable

Elasticity superior to vinyl but below latex

Contains no latex proteins but some chemical accelerators



Julie's Story Continued

In 2008, the FDA approved patient examination gloves made from guayule.

Julie asked her doctor about her symptoms and he referred her to an allergist. The allergist suspected latex allergy based on her history and did a scratch test. Within minutes of the latex solution application, her arm became swollen, red, and itchy. Spirometry indicated that Julie has asthma, and since it had not been previously documented in her medical record, the allergist diagnosed latex allergy-induced asthma. Julie can no longer work in the ICU, so the employee health nurse is helping her find another job within the hospital that will be safe for her.


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