Biomechanical performance of examination gloves

Perforations of tri-layer nitrile-latex and natural rubber latex gloves during ex-vivo equine intestinal anastomoses

OBJECTIVE

To compare perforation rates between tri-layer nitrile-latex and natural rubber latex surgical gloves after single-layer end-to-end jejunojejunal anastomoses in equine cadavers.

STUDY DESIGN

Prospective randomized ex-vivo study.

SAMPLE POPULATION

Pairs of surgical gloves (n = 46) worn during jejunojejunal anastomoses.

METHODS

Tri-layer nitrile-latex and rubber latex pairs of gloves were equally but randomly allocated to a right-handed surgeon performing 46 single-layer end-to-end jejunojejunal anastomoses on cadaveric material. Number and location of perforations were determined with the water leak test after each procedure. Ten unused pairs of both glove types were tested as controls.

RESULTS

At least one perforation occurred in 41% (19/46) of the pairs of gloves. Glove perforations were present in 22% (5/23; 95% CI: 9-42) of tri-layer glove pairs and 61% (14/23; 95% CI: 41-78) of the rubber glove pairs. The odds of glove perforation were 5.6 times (p = .009, 95% CI: 1.5-20.5) lower when tri-layer rather than rubber gloves were used. The duration of procedure did not affect the risk of glove perforation (p = .679). No perforations were observed in the unused gloves.

CONCLUSION

Perforations were less common when the surgeon wore tri-layer nitrile-latex gloves rather than to the natural rubber latex gloves tested in this study.

CLINICAL RELEVANCE

Tri-layer nitrile-latex gloves were more resistant to perforations in experimental settings; further studies may confirm that they are also superior in a clinical setting.

Integrity of disposable nitrile exam gloves exposed to simulated movement

Every year, millions of health care, first responder, and industry workers are exposed to chemical and biological hazards. Disposable nitrile gloves are a common choice as both a chemical and physical barrier to these hazards, especially as an alternative to natural latex gloves. However, glove selection is complicated by the availability of several types or formulations of nitrile gloves, such as low-modulus, medical grade, low filler, and cleanroom products. This study evaluated the influence of simulated movement on the physical integrity (i.e., holes) of different nitrile exam glove brands and types. Thirty glove products were evaluated out-of-box and after exposure to simulated whole-glove movement for 2 hr. In lieu of the traditional 1 L water-leak test, a modified water-leak test, standardized to detect a 0.15 ± 0.05 mm hole in different regions of the glove, was developed. A specialized air inflation method simulated bidirectional stretching and whole-glove movement. A worst-case scenario with maximum stretching was evaluated. On average, movement did not have a significant effect on glove integrity (chi-square; p=0.068). The average effect was less than 1% between no movement (1.5%) and movement (2.1%) exposures. However, there was significant variability in glove integrity between different glove types (p≤0.05). Cleanroom gloves, on average, had the highest percentage of leaks, and 50% failed the water-leak test. Low-modulus and medical grade gloves had the lowest percentages of leaks, and no products failed the water-leak test. Variability in polymer formulation was suspected to account for the observed discrepancies, as well as the inability of the traditional 1 L water-leak test to detect holes in finger/thumb regions. Unexpectedly, greater than 80% of the glove defects were observed in the finger and thumb regions. It is recommended that existing water-leak tests be re-evaluated and standardized to account for product variability.

Failure rates in nonlatex surgical gloves

BACKGROUND

The purpose of this study was to compare the frequency of glove defects for nonlatex surgical gloves while surgeons performed routine surgery and to evaluate surgeons' satisfaction with nonlatex sterile gloves.

METHODS

Two brands of latex gloves and 6 brands of nonlatex gloves were tested. Gloves were collected at the end of each surgical procedure and tested for visual defects and barrier integrity using an automated calibrated water test machine consistent with FDA's recommended standards. A total of 6386 gloves used by 101 surgeons and 164 residents representing 15 surgical services were included in the analysis.

RESULTS

Higher after-use defect rates occurred in nonlatex surgical gloves than in latex gloves. Higher times of use were related to higher defect rates for some surgical specialties, and both surgeons and residents were less satisfied with nonlatex surgical gloves.

CONCLUSION

Intact latex and nonlatex surgical gloves provide adequate barrier protection. Nonlatex surgical gloves have higher failure rates and lower user satisfaction than latex gloves do. Both nonlatex and latex gloves should be changed after 2 to 3 hours of use because the barrier of either type of glove becomes compromised with extended use.

Puncture resistance and stiffness of nitrile and latex dental examination gloves

OBJECTIVE

The aim of the current study was to assess the puncture resistance and stiffness of nitrile and latex dental examination gloves.

METHODS

Puncture resistance was measured by employing an adapted version of ASTM F1342-91 using both a 316 stainless steel puncture probe (0.8 mm diameter) and a dental injection needle (0.45 mm diameter) interfaced to a tensile testing apparatus. Glove specimens (12 cm length, 1.5 cm breadth) were removed for modulus (M100) evaluation by assessing the force required to elongate the specimen to 100% of the original length. Glove samples were also aged to investigate whether puncture resistance and M100 values varied with aging at 70 degrees C for 7 days in an air-circulating oven.

RESULTS

The nitrile glove types were assessed to have significantly higher puncture resistance compared with the latex glove type when the steel puncture probe was the pentrometer when using the one way analysis of variance (ANOVA) at the 95% significance level. Interestingly the puncture resistance for the latex glove type was significantly higher (P < 0.001) when a dental injection needle was used as the pentrometer compared with the nitrile glove types. The M100 values were significantly higher for the nitrile glove types for which the stiffness increased when the gloves were aged (P < 0.001).

CONCLUSIONS

The higher stiffness values resulted in increased puncture resistance when the nitrile glove specimens were aged irrespective of the pentrometer type. However, the ability of latex to re-seal itself on puncture may be beneficial when considering the protection potential of each glove type against breaches in cross infection. For clinicians that have experienced an adverse reaction to natural latex gloves, the results of the current study indicate that nitrile gloves are available at reasonable cost and offer the clinician comparable resistance to puncture with latex gloves.

An assessment of the incidence of punctures in latex and non-latex dental examination gloves in routine clinical practice

OBJECTIVE

To investigate the puncture resistance of a recently introduced non-latex, nitrile dental glove in comparison with a latex glove worn during routine clinical dental procedures.

SETTING

Dentists in general dental practice working within the UK during 1999.

SUBJECTS AND METHODS

2,020 gloves worn by five general dental practitioners were examined for punctures following standard clinical use by a water inflation method. Procedures undertaken during glove usage and length of time worn were recorded.

RESULTS

Following clinical use, 1.9% of the latex gloves and 5.3% of the nitrile gloves had punctures, a statistically significant difference (P < 0.0001). The puncture resistance of the nitrile gloves was superior to the puncture resistance of previously tested worn non-latex (vinyl) gloves. There was no evidence of a statistically significant difference between operators for the percentage or incidence of punctured gloves (P = 0.787) after correcting for glove type. No statistically significant difference was noted between incidence of puncture in the control, unused gloves (n = 200 for each type) and the gloves examined following clinical use (P = 0.907 for nitrile, P = 0.613 for latex).

CONCLUSION

No increase in the number of punctures was noted following clinical use for either glove type. This could be considered to indicate good puncture resistance of the gloves tested in clinical use.