A laboratory-based study to assess the performance of surgical gloves

AORN Journal, April, 2003 by Denis M. Korniewicz, Maher M. El-Masri, John M. Broyles, Christopher D. Martin, Kevin P. O'Connell

In assessing for possible confounding effects among the study variables, powder was significantly associated with stress ([X.sup.2] = 9.52, P = .001), material ([X.sup.2] = 1,320; P < .001), and manufacturer ([X.sup.2] = 1,902; P < .001). Stress had a significant association with manufacturer ([X.sup.2] = 20.94, P = .001) but not with material ([X.sup.2] = 6.17, P = .104). The association between material and manufacturer also was found to be significant ([X.sup.2] = 7,515; P < .001). These associations suggested confounding effects among the study variables; therefore, a statistical adjustment was completed by multivariate logistic regression analysis. It is worthy to note that the data in the initial multivariate model did not converge due to M1 and M6 having similar manufacturing qualities and M4 and M5 having similar manufacturing qualities after adjusting for glove material. Therefore, M1 and M6 were grouped in one category (M1/M6) and M4 and M5 were grouped in another category (M4/M5).

After statistically adjusting for glove stress, material, and manufacturer, defect rates between powdered and nonpowdered gloves were not significantly different (odds ratio [OR] = 1.48, 95% confidence interval [C[I.sup.95]] = 0.69-3.16) even though the defect rate in powdered gloves was 1.48 times that of nonpowdered gloves (Table 3). When statistically adjusted for powder, material, and manufacturer, the stressed gloves had higher defect rates than the unstressed gloves (OR = 4.26, C[I.sup.95] = 2.92-6.21). When controlling for type of material, powder, stress, and manufacturer, isoprene gloves had higher defect rates than latex (OR = 8.91, C[I.sup.95] = 4.85-16.35), and neoprene did not differ from latex (OR = 0.95, C[I.sup.95] = 0.47-1.93). Defect rates of nitrile gloves were not significantly different than those of latex gloves despite an odds ratio of 2.36. Defect rates of M4/M5 were lower than those of the remaining three manufacturer categories.

DISCUSSION

The findings demonstrate that glove material, manufacturer, and stress during use were important factors in determining the barrier quality of surgical gloves. Stress was not a confounding factor; when gloves were stressed, the likelihood for failure increased approximately 4.26 times regardless of the glove material, manufacturer, or effect of powder.

When failure rates of different glove materials were compared using univariate analysis, latex had a lower defect rate than isoprene, comparable defect rate to neoprene, and higher defect rate than nitrile. Powder, manufacturer, and stress were important variables to review, however, because they showed that latex was not a poor choice but was comparable to nitrile. The findings suggest that when nitrile and latex are viewed in isolation, one would assume the defect rate of nitrile gloves was three times lower than the defect rate of latex gloves. Readers also should note that all nitrile gloves tested were made by M4. In this study, M4/M5 was found to have the lowest defect rate. Latex gloves all were made by M1 and M6. The defect rate for M1/M6 was eight times higher than that of M4/M5. After adjusting for glove manufacturer, therefore, durability of latex and nitrile gloves was comparable. These findings explain the importance of statistical adjustment for glove manufacturer when determining the durability of different glove materials. This was supported by researchers (18) who found that there were differences in the quality and durability of surgical gloves among manufacturers when gloves were tested after use. (19)