The changing face of hand protection - Home Study Program - Statistical Data Included

AORN Journal,  August, 2002  by Peter B. Graves,  Carolyn L. Twomey

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Polymers or block polymers. Gloves made from the polymer SBR do not contain natural rubber latex. Like latex, however, this material is sensitive to ozone; thus, antioxidants must be added. When antioxidants or other chemical are added, the potential always exists for health care workers who already are sensitive to the chemical to develop type IV skin reactions (eg, contact dermatitis). Based on this, users should verify the amounts and types of chemicals found in gloves. (27) Styrene-butadiene rubber has a lower elasticity and tensile strength than latex, and current formulations disintegrate upon contact with uncured polymethyl methacrylate (ie, bone cement). (28)

Block polymers include a variety of short chain polymer products. The block polymer material is a combination of styrene and a second polymer, such as butadiene or isoprene (eg, SEBS). Gloves made with this clear to opaque material will degrade rapidly or disintegrate within seconds of contact with uncured polymethyl methacrylate. This family of glove materials, therefore, is not well suited for every surgical application and can create significant risk management, employee health, and infection control issues. Gloves made from either SBR or SEBS materials should avoid contact with polymethyl methacrylate. (29)

Polyisoprene. Polyisoprene is a new synthetic material that has a molecular structure identical to natural rubber latex but without the natural rubber latex proteins. Polyisoprene exhibits many of the characteristics of natural rubber latex, but it currently is more expensive than latex.

Polyurethane. Polyurethane has been on and off the market for several years. Gloves made with polyurethane are relatively intolerant of common medical alcohols. When polyurethane gloves are exposed to alcohol, such as that found in chromic and plain gut suture packages, they begin to break down, lose tensile strength, and eventually fail. Care must be exercised, therefore, when handling alcohols with polyurethane gloves. (30)

THE NEXT STEP

What is the next step? Many facilities defer the evaluation of these synthetic materials to members of the purchasing department. Although care should be exercised when allowing nonclinical staff members to make decisions about personal protective devices, purchasing staff members must be included in the process to guarantee compliance with contracts and secure the best pricing and samples.

When evaluating natural rubber latex or synthetic glove materials, there are many facets and issues to be concerned with other than price. (31) Buyers should solicit and evaluate data supplied by manufacturers and the current clinical literature to determine whether the product can meet the demands of the task.

Another issue that is critical is distinguishing nonlatex gloves from those containing natural rubber latex. It is essential that nurses and other perioperative staff members be able to conduct a quick visual survey of an OR to verify whether it is safe for a patient with latex allergy. By choosing nonlatex gloves that have a distinctive color, health care workers can verify visually whether everyone is wearing nonlatex gloves. This also simplifies the implementation of a latex allergy protocol and verifies staff members' competency for working with patients and other health care workers who have natural rubber latex allergy.