Surgical Gloves in health care

1. SURGICAL GLOVES
IN HEALTH CARE
Dr.T.V.Rao MD
2/20/2016 Dr.T.V.Rao MD 1

2. WHAT IS A GLOVE
•A glove (Middle English
from Old English glof) is a
garment covering the
whole hand. Gloves have
separate sheaths or
openings for each finger
and the thumb; if there is
an opening but no (or a
short) covering sheath
for each finger they are
called fingerless gloves.
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3. History of Gloves
• Gloves appear to be of great antiquity. According to some translations of
Homer'sThe Odyssey, Laërtes is described as wearing gloves while
walking in his garden so as to avoid the brambles. (Other translations,
however, insist that Laertes pulled his long sleeves over his hands.)
Herodotus, inThe History of Herodotus (440 BC), tells how Leotychides
was incriminated by a glove (gauntlet) full of silver that he received as a
bribe.There are occasional references to the use of gloves among the
Romans as well. Pliny theYounger (c. 100), his uncle's shorthand writer
wore gloves in winter so as not to impede the elder Pliny's work.
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4. Rubber Glove
• A rubber glove is a glove made out of rubber. Rubber gloves can be
unsupported (rubber only) or supported (rubber coating of textile
glove). Its primary purpose is protection of the hands while
performing tasks involving chemicals. Rubber gloves can be worn
during dishwashing to protect the hands from detergent and allow
the use of hotter water. Sometimes caregivers will use rubber gloves
during the diaper changing process to prevent contact with the child's
fecal material/urine. Health professionals use medical gloves rather
than rubber gloves when performing surgical operations.
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5. Gloves
Patient care, environmental services, other
• Glove material – vinyl, latex, nitrile, other
• Sterile or non-sterile
• One or two pair
• Single use or reusable
PPE Use in Healthcare Settings2/20/2016 Dr.T.V.Rao MD 5

6. Medical gloves
• Medical gloves are examples of
personal protective equipment
that are used to protect the
wearer and/or the patient from
the spread of infection or illness
during medical procedures and
examinations. Medical gloves
are one part of an infection-
control strategy.
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7. Medical gloves
• Medical gloves are disposable and
include examination gloves,
surgical gloves, and medical gloves
for handling chemotherapy agents
(chemotherapy gloves).These
gloves are regulated by the FDA as
Class I reserved medical devices
that require a 510(k) premarket
notification. FDA reviews these
devices to ensure that performance
criteria such as leak resistance, tear
resistance and biocompatibility are
met.
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8. What gloves should be worn?
•The gloves worn
should be able to
provide protection
from exposure to
blood-borne viruses
for the duration of
the tasks being
undertaken.
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9. What gloves should be worn?
•This may mean having to
change them safely mid-
task if they become
damaged, and/or having
to wear a combination of
more than one type of
glove to provide
additional physical
protection:
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10. What you should know before using
medical gloves
•Wash your hands before
putting on sterile gloves.
••Make sure your gloves fit
properly for you to wear
them comfortably during
all patient care activities.
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11. Caution using the Gloves
• Be aware that sharp objects can puncture medical gloves.
• •Always change your gloves if they rip or tear.
• •After removing gloves, wash your hands thoroughly with
soap and water or alcohol-based hand rub.
• •Never reuse medical gloves.
• •Never wash or disinfect medical gloves.
• •Never share medical gloves with other users.
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12. Do’s and Don’ts of Glove Use
• Work Opportunities from “clean to dirty”
• for “touch contamination” -
protect yourself, others, and the environment
– Don’t touch your face or adjust PPE with contaminated
gloves
– Don’t touch environmental surfaces except as necessary
during patient care
PPE Use in Healthcare Settings2/20/2016 Dr.T.V.Rao MD 12

13. How to Don Gloves
• Don gloves last
• Select correct type and size
• Insert hands into gloves
• Extend gloves over isolation gown
cuffs
PPE Use in Healthcare Settings2/20/2016 Dr.T.V.Rao MD 13

14. How to Safely Use PPE
• Keep gloved hands away from face
• Avoid touching or adjusting other PPE
• Remove gloves if they become torn;
perform hand hygiene before donning
new gloves
• Limit surfaces and items touched
PPE Use in Healthcare Settings2/20/2016 Dr.T.V.Rao MD 14

15. Sequence for Removing PPE
• Gloves FIRST
• Face shield or goggles
• Gown
• Mask or respirator
PPE Use in Healthcare Settings2/20/2016 Dr.T.V.Rao MD 15

16. Where to Remove Gloves
• At doorway, before leaving patient room or in
anteroom*
• Remove respirator outside room, after door has
been closed*
* Ensure that hand hygiene facilities are
available at the point needed, e.g., sink or
alcohol-based hand rub
PPE Use in Healthcare Settings2/20/2016 Dr.T.V.Rao MD 16

17. How to Remove Gloves (1)
• Grasp outside edge
near wrist
• Peel away from hand,
turning glove inside-out
• Hold in opposite gloved
hand
PPE Use in Healthcare Settings2/20/2016 Dr.T.V.Rao MD 17

18. How to Remove Gloves (2)
• Slide ungloved finger
under the wrist of
the remaining glove
• Peel off from inside,
creating a bag for
both gloves
• Discard
PPE Use in Healthcare Settings2/20/2016 Dr.T.V.Rao MD 18

19. When to do Double gloving
•For some surgical work eg,
orthopaedic or dentistry,
where additional physical
protection may be needed,
double gloving, the use of
glove liners or of knitted or
steel weave outer gloves
may be appropriate and are
proven to be beneficial.
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20. Use of Gloves in Post-mortem
examination
• For some work, such as post
mortem examination or
embalming, where there is
a risk of exposure to blood-
borne viruses as well as the
requirement to use knives,
saws etc, pierce and cut-
resistant gloves are likely to
be needed, in addition to
those providing
microbiological protection.
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21. Allergies with Gloves
•Latex allergies are becoming common with
prolonged use of latex gloves, and the use of nitrile
or vinyl gloves is recommended to avoid becoming
sensitised. It is recognised, however, that within
certain work environments, latex gloves are still
used in large numbers due to their efficacy and
relatively low cost.
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22. Allergies with Gloves
•If latex gloves are worn, then powder free, low
protein content materials must be chosen to help
prevent latex allergy. Powdered gloves should be
avoided as they can increase skin irritation and the
likelihood of allergy development.Where latex
gloves are in use appropriate health surveillance
should be implemented.
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23. Hand hygiene and disposable gloves
• It is important to remember that glove use is not a replacement
for effective hand washing, and the two should work together to
protect the wearer and others, such as a patient or client being
treated. Key requirements are:
• When using disposable type gloves, your hands should be washed
and dried thoroughly before putting the gloves on;
• Where client or patient treatments are involved, a fresh pair of
disposable examination-style gloves must be worn for each
procedure and must be disposed of between procedures to avoid
cross-infection. Never wash and reuse disposable gloves;
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24. Gloving is not Replacement for Hand Washing
We should not forget HandWashing is great step in prevention of
spread of Infectious diseases
• If you work anywhere in the health care industry, you are likely
aware of the importance of performing proper hand hygiene and
glove use to reduce the spread of infectious organisms.
• In the “Five Moments for Hand Hygiene” as outlined by the World
Health Organization (WHO,) the first “moment” for performing
hand hygiene is Before Patient Contact.
• But is this step really necessary, especially when you are about to
don a pair of gloves before touching the patient?
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25. Gloving is not Replacement for Hand Washing
We should not forget Hand Washing is great step in
prevention of spread of Infectious diseases
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26. Hand Hygiene and Disposable gloves
•If you need to stop work temporarily, eg to answer a phone,
always remove and discard the gloves you are wearing and
replace them when you continue working;
•Always wash your hands after glove removal - gloves are not a
replacement for hand washing; and,
•Moisturising hand cream, applied after hand washing, can help
prevent skin drying after frequent washing. Such products
should never be relied upon as a physical barrier to protect the
skin from infection.
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27. References
•1The use of gloves Health and safety executive
internet resource
•2 Guidance for the Selection and Use of Personal
Protective Equipment (PPE) in Healthcare
Settings CDC resource
•Medical Gloves FDA
•Wikipedia on Gloves
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29. •Program file crated by Dr.T.V.Rao MD for
benefit of Medical and Paramedical
Professionals in the Developing World for
Scientific use of Surgical Gloves
•Dr.T.V.Rao MD
•Freelance Clinical Microbiologist
2/20/2016 Dr.T.V.Rao MD 29