FIT-AND-FEEL TRIALS Let every member of the surgical team trial non-latex models.

When non-latex gloves hit the market about 20 years ago, they were noticeably different from their latex counterparts — and not in a good way. They were tougher, stiffer, more prone to tearing, and less tactile and sensitive, too. They were also harder to double-glove, which frustrated many. Plus, with the price of non-latex considerably higher than latex, many didn't see the value in switching to a less satisfying product.

But in response to a surge in latex allergies among both patients and providers, glove manufacturers have steadily answered all of these concerns over the years — including the price disparity. Today's non-latex gloves hold their own against latex in terms of sensitivity, tactility and certainly durability. Still, you can expect some pushback from surgeons and staff who might be wary of non-latex gloves when you set out to make a full or partial conversion.

"The most common complaints about non-latex gloves are still that people aren't used to them," says Robert Brown, MD, professor of anesthesiology at Johns Hopkins University School of Medicine in Baltimore, Md. "Some surgeons say they can't work as well as they do with latex."

Don't expect the switch to non-latex to magically happen overnight. It took Sam Sullivan, RN, 3 years to convert the University of Rochester (N.Y.) Medical Center exclusively to non-latex gloves. Only when he couched the issue in its most crucial tenet of safety did non-latex really catch on with staff, says Mr. Sullivan.

Gloves touch all OR team members, but keep in mind that surgeons can become very attached to their gloves and highly emotional if you ask them to switch. For some, there is no other glove but the one they trained in, the one they're used to, the one they like.

"It takes a whole systemic change, right through to purchasing," says Robert Hamilton, PhD, a professor of pathology at Johns Hopkins University School of Medicine.

You need a literal hands-on approach. Organize glove trials so people can touch the gloves you want them to wear. "If you want your facility to make the switch, you need to involve all impacted parties in the process," adds Dr. Brown. "Have fit-and-feel demonstrations. Give different models a trial."

Here's a look at the different materials used to manufacture non-latex gloves:

Polyisoprene. When it comes to mimicking latex gloves, polyisoprene cuts it closest. Providers who choose polyisoprene typically report comfort and elasticity levels that match latex, and current models often feature a polymer lining that makes them easier to wear over damp or dry hands. The catch with this material is its higher cost.

Neoprene. This material experienced the most tearing in the early days of non-latex gloves. Neoprene started out stiffer and less elastic, which made it more susceptible to damage, but over the years, many neoprene models have overcome previous flaws and become sturdier and more reliable. In fact, the toughness of neoprene is what gives it its strength: excellent barrier protection (osmag.net/Bxu5KN). Neoprene is less prone to punctures, and although pricier than latex, it's generally cheaper than polyisoprene.

Nitrile. The primary quality of nitrile is exceptional durability. It also has 3 to 5 times the puncture-resistance of latex, which offers added protection against sharps and sticks. It also has a micro-roughened texture, which makes for a stronger and more tactile grip. Recent design improvements have also made nitrile gloves thinner and more flexible (osmag.net/KPgC8z).

Don and decide
Glove manufacturers will be more than happy to help you trial their products. How do the gloves fit? Are they comfortable? Do they stand up to the rigors of surgery? Do they have tactile sensitivity? Make sure you gather responses until you gain enough of a consensus to make the best choice possible.

The Lean Team at the University of Rochester invited one glove manufacturer in for a 2-week trial, and the company brought in 100 boxes of different non-latex models for staff and surgeons to try on, says Mr. Sullivan, who adds that purchasing from a sole vendor lets you bundle and save as much as possible.

Thomas Durick, MD, a California anesthesiologist with Medical Anesthesia Consultants, also advocates for narrowing the field. "We had many options, but knew we'd never reach a consensus — especially among surgeons who were already wary of non-latex gloves — if we sampled all the choices," says Dr. Durick, who practices primarily at Fremont (Calif.) Surgery Center. OSM

Ansell Healthcare
Gammex
ansell.com/healthcare
(800) 952-9916
FYI: The new Gammex PI Hybrid is made from a 50/50 blend of polyisoprene and neoprene that intertwine to form crosslinks between the polymers, which provides a surgical glove that features both the comfort of polyisoprene while also displaying the higher strength and durability associated with neoprene. The Gammex PI Hybrid is also semi-transparent, a feature which makes it a fit as an outer glove in a double-gloving system, especially when combined with a dark underglove. Plus, according to Ansell, the glove is micro-thin and elastic without compromising durability.

Cardinal Health
Protexis
cardinalhealth.com/surgicalgloves
(800) 964-5227
FYI: The Protexis PI line of non-latex gloves features a polyisoprene base for latex-like comfort. Cardinal Health pays particular attention to designing its line with independent thumb motion, allowing what it claims to be more natural anatomical hand motion. The Protexis PI line also comes with a proprietary interlocking, beaded cuff design to reduce roll-down of the sleeves. The classic model allows for strong independent thumb motion over a range of procedures; the orthopedic model features more durability; and the micro design is thinner, more elastic and semi-transparent, which makes it a suitable outer partner in a double-gloving system.

Medline Industries
SensiCare
medline.com
(800) MEDLINE
FYI: Medline's line of non-latex polyisoprene gloves, the SensiCare PI family, includes 4 gloves: a standard thickness SensiCare PI, which is comparable to latex and has a smooth grip; micro-thin SensiCare PI Micro for enhanced sensitivity and tactility; SensiCare PI Ortho, which provides extra barrier protection without losing elasticity or softness; and an underglove, SensiCare PI Green. Each SensiCare PI glove features a polymer coating, which eases donning for damp and dry hands, as well as an anti-roll cuff to prevent the sleeve from rolling down and out of place, says the company.

M??lnlycke Health Care
Biogel
molnlycke.us
(800) 843-8497
FYI: Biogel gloves feature a powder-free, polymer coating with hydrophilic properties that are meant to conform to damp or dry hands. According to the company's own research, 94% of surgeons rated the comfort of Biogel polyisoprene synthetic gloves as good or better than Biogel Latex. Biogel gloves are manufactured using a proprietary process and are tested through 13 quality checks, according to the company, including water leak testing, air inflation and visual inspection. The company touts the durability of Biogel PI gloves, which, although more expensive than latex, are less susceptible to damage and therefore reduce long-term inventory costs.