Choosing gloves is a hands-on process
Different materials, uses, features require study
While natural rubber latex is still the gold standard by which all other surgical glove materials are measured, there are a variety of other synthetic materials that may be appropriate for a same-day surgery program when natural rubber latex does not work for one reason or another.
"Most of our physicians and operating room staff members prefer natural rubber latex [gloves] because they believe they fit and feel better than synthetic materials," says Janet Greenfield, assistant vice president of HealthSouth, a national company that owns health care facilities including four same-day surgery programs in Redlands, CA, where Greenfield is located.
Physicians and staff probably prefer natural rubber latex because it is the material people have been using the longest and they are more accustomed to it, admits Greenfield. Her facilities do, however, purchase other types of gloves if a physician or staff member wants them. "The most common reasons for purchasing another type of glove are allergies and personal preference," she says.
Milt Hinsch, MS, technical service director for Regent Medical, a glove manufacturer in Norcross, GA, says, "It’s hard to beat natural rubber latex for gloves." There are some very real advantages to using natural rubber latex, but if it cannot be used — due to a user’s or a patient’s allergy — the new synthetic materials offer some safe alternatives, he says.
While natural rubber latex gloves can come in a variety of thicknesses, ranging from 7 mL for ophthalmic procedures that require tactile sensitivity to a thickness of 13-14 mL for orthopedic procedures in which the surgeon is more likely to encounter sharp objects that can tear the glove, synthetics offer less variety, says Hinsch. The most typical surgical glove is 8-10 mL thick, he adds.
There are four synthetics that are commonly used for most surgical gloves, says Hinsch:
• Polychloroprene. "Polychloroprene represents only 2% to 3% of the market, so these gloves are typically available only in the 8-10 mL thickness range," says Hinsch. Polychloroprene gloves tend to be stiff at first, so hands might fatigue more quickly, he adds. These gloves are more expensive, but they are a good alternative when there is a latex allergy, and Hinsch predicts the price will come down as more people use them.
• Styrene-butadiene rubber (SBR), styrene-ethylene-butadiene-styrene (SEBS). "Gloves made with SBR and SEBS have been used when there is a latex allergy involved, but they cannot be used with orthopedic procedures because they dissolve when they come into contact with uncured bone cement," Hinsch points out.
• Polyurethane. The biggest disadvantage with polyurethane gloves is that they dissolve when they come in contact with common alcohols, says Hinsch. "Two to three minutes after contact with alcohol, the gloves become gummy and slippery," he says.
When evaluating synthetic gloves, be aware that synthetics meet a lower manufacturing standard than natural rubber latex gloves, says Hinsch. "If all synthetics were required to meet the same standards of natural rubber latex, we would not have had any other materials developed," he points out. Synthetics provide an alternative when natural rubber latex gloves are in short supply, and Hinsch points out that "all gloves are inherently safe if they are durable enough for the procedure being performed and are used properly."
One change that has occurred within the natural-rubber-latex-glove market in the last three years was the move to powder-free gloves. Some physicians and staff are allergic to the powder used in gloves, says Greenfield. "In the beginning, powder-free gloves were very expensive, but as our purchasing groups learned more and as the manufacturers learned more, the costs began to come down," she says.
"There is some powder-like substance used in all glove manufacturing processes," Hinsch points out. "Powder is necessary to release the glove from the form," he explains. The expense of powder-free gloves comes after the glove is made because extra steps must be taken to remove the powder and add a coating inside the glove to make it easy to put on the hand, he says.
Even with the alternatives to traditional, powdered natural rubber latex gloves, people are wary of making changes, says Greenfield. "There is no evaluation process hated more than glove evaluation," she says. Because gloves are an integral part of every surgeon’s and operating staff member’s jobs, any difference in the glove being evaluated is noticed, she says.
If you do plan to change gloves, go slowly, advised Hinsch. "Set up a committee that represents everyone who will use the gloves, give inservices, and most importantly, give everyone time to get used to the gloves," he adds.
Overall, gloves are a small expense for most same-day surgery programs, says Greenfield. She tries to provide a variety of gloves if physicians or staff members make special requests. She points out, "Providing a specific glove is an easy fix for an unhappy doctor."
Sources
For more information about choosing surgical gloves, contact:
• Milt Hinsch, MS, Technical Services Director, Regent Medical, 3585 Engineering Drive, Suite 200, Norcross, GA 30092. Telephone: (770) 582-2111.
• Janet Greenfield, Assistant Vice President, HealthSouth, 1620 Laurel Ave., Redlands, CA 92373. E-mail: [email protected].
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