Glove makers have responded to the need for alternatives to natural rubber latex surgical and exam gloves in a big way. Like you, they're increasingly aware of the hazards of latex allergy. As you'll see in "Gloves at a Glance" on page 62, nitrile has become the primary replacement for latex in ambidextrous exam gloves and most latex-free surgical gloves are made of polyisoprene, a synthetic version of a natural rubber latex component.

Most non-latex options are made of synthetic alternatives such as nitrile, polyisoprene, polychloroprene and polyvinyl chloride. Largely petroleum-based, these materials offer comparable strength, performance, fit and comfort, but without the proteins found in natural rubber latex that threaten to build or trigger allergic reactions.

• Nitrile. Can be manufactured into a thinner glove than other materials, fitting its short-duration, less-intensive use.
• Polyisoprene. When produced synthetically, it's identical in molecular structure to natural rubber latex, only without the potentially allergenic proteins. Polyisoprene gloves are frequently touted as offering the same benefits of latex gloves with none of the risks.
• Polychloroprene and polyvinyl chloride (PVC). Thin, elastic and often costing less than other alternative materials.

How well gloves made from synthetic materials compare to the fit, feel and performance of natural rubber latex gloves is a subjective observation, and one perhaps best answered by your own staff through a hands-on trial. Technical specifications, however, can provide a starting point.

In addition to each glove's thickness (listed in millimeters at the fingertip and, where available, at the palm), consider manufacturers' data on tensile strength and elongation.

• Tensile strength. Represents the amount of force that is required to puncture a surgical glove. It is measured in megapascals (MPa), a metric unit of pressure approximating 145 pounds per square inch. A higher number suggests a stronger glove. The test is often done before and after accelerated aging stress tests ("unaged" and "aged").
• Elongation. Represents a glove's elasticity, measuring how far beyond its normal manufactured length it can be stretched before it breaks.

Latex gloves have often been treated with cornstarch or other powder to aid in donning. This powder absorbs the latex's proteins and can lead to skin and respiratory irritation and allergic sensitivity. Many latex gloves are now washed or soaked to reduce the amount of protein they contain as well as residual chemicals used in the manufacturing process, and many are manufactured powder-free.

While synthetic gloves contain no latex proteins, many of them are manufactured powder-free as well, given clinical studies' suggestions that glove powder in and of itself has negative effects on wound closure, surgical site infection prevention and post-op healing. More gloves are now treated with polymer coatings or lubricants for ease of donning, which may also be formulated to provide the additional benefit of skin moisturization.

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