Using gloves coated with a dermal therapy formula to improve skin condition

AORN Journal,  Jan, 2005  by Deborah D. Davis,  Robert A. Harper

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Frequent exposure of hands to conditions and agents that compromise the skin's normal barrier properties makes contact dermatitis an occupational health risk for nurses and other health care workers. Hand washing not only removes obvious contamination and skin microbes, it also removes layers of epithelial cells and their associated skin lipids. (1) Alcohol-based rubs can replace some portion of hand washing, but repeated use of these hand rubs for skin antisepsis can lead to dry skin. (2)

The magnitude of the problem of contact dermatitis among nurses was confirmed in a 1997 study of 410 acute care nurses. (1) Approximately 25% of these nurses had signs or symptoms of dermatitis on their hands at the time of the survey, and 86% had a history of skin problems on their hands.

Use of antimicrobial soaps and lengthy scrubs required by presurgical hand antisepsis protocols may put perioperative nurses at high risk of developing hand irritation. Use of brushes in surgical scrubs can further increase the risk of skin damage. (3)

Infection Control

The ramifications of chronic dermatitis among nurses reach beyond the issue of personal discomfort and into the issue of infection control. Dry, irritated skin can be linked to an increased chance of transmission of pathogens between nurses and patients. Dry, irritated skin is more difficult to disinfect than healthy skin, (4) and it is more likely to be colonized with nonresident pathogenic bacteria, which are responsible for most health care-associated infections. (5,6) Flaking associated with dry, irritated skin further increases the risk of transmitting infection because of the larger numbers of microorganisms shed into the environment with the skin flakes. (7) Irritated skin also has been shown to deter health care workers from washing their hands, which is a fundamental part of hand hygiene. (8)

The use of skin emollients or barrier creams to prevent contact dermatitis is receiving new attention. (9) For example, the "Guideline for hand hygiene in health-care settings" (2) published by the Centers for Disease Control and Prevention (CDC) now recommends that health care workers be provided with hand lotions or creams to reduce the occurrence of irritant contact dermatitis and the associated increased risk of health care-associated infection transmission. (2) In addition, AORN's 2004 Standards, Recommended Practices, and Guidelines includes information on choosing appropriate skin moisturizing products to prevent dermatitis and reduce bacterial shedding from the skin. (10)

Reasons for Poor Adherence

Nurses' ability to comply with the recommended use of hand creams, however, is questionable. High patient loads are known to be associated with poor adherence to hand hygiene, (11) which suggests that nurses who are too busy to wash their hands or use hand rubs between patients are unlikely to have time to apply hand cream between patients.

Nurses need products that make it easier for them to moisturize, soothe, and protect their hands to reduce contact dermatitis and the number of health care-associated Infections. For this reason, surgical gloves coated with a dermal therapy formula were developed. The gloves are coated with a proprietary blend of ingredients that have established roles in skin health and long histories of use in skin, hair, and nail care products. (12-21) The ingredients in the coating, either Individually or in combination, are known to moisturize, aid in skin repair, and contribute to maintenance and protection of the skin barrier (Table 1). (12-21)

One study compared the effects on skin health of using surgical gloves coated with a dermal therapy formula to using equivalent surgical gloves without the formula. (22) The study found that gloves coated with the formula produced an increase in skin moisture and skin elasticity from baseline levels. It also found that gloves with a dermal therapy formula caused less deterioration in skin integrity as measured by transepidermal water loss than did gloves without the coating.

A One-Day Study

The single-day study that is the focus of this article provided perioperative nurses and other health care workers an opportunity to evaluate the effects of a surgical glove coated with a dermal therapy formula on the overall condition of the skin on their hands. The participants used a self-assessment to report what they found.

A total of 31 health care workers completed the self-assessment. Two of the participants were male, and the rest were female. Participants ranged in age from 30 to 59 years. Twenty-four (77%) study participants were perioperative nurses. The remaining seven participants included two medical/ surgical nurses, three physical and occupational therapists, a medical assistant, and a laboratory technician. All study participants worked in positions that require them to use gloves several times during the day.

Participants were instructed to avoid using creams or lotions on their hands for 24 hours before the self-assessment. On the day of the assessment, the participants performed a surgical scrub and then completed a two-page questionnaire about hand cleansing and the lotion products they normally use at work, their perception of causes of dry skin, and benefits they associate with certain ingredients commonly found in hand lotions. Participants were asked to rate the feel and appearance of the skin on their hands according to six criteria: