DID YOU KNOW?

Between 8 percent and 12 percent of healthcare workers are at risk for latex allergies, says the CDC. Among the general population, the at-risk number is far less - between 1 percent and 6 percent.

Surgical facilities have heeded safety experts' calls to move away from latex gloves and, thus, the potential for latex-protein sensitization and anaphylactic reactions to natural rubber. And they're doing so in greater numbers than ever before.

Through the third quarter of 2005, latex-free (synthetic) surgical glove sales were up $21 million over all of 2004, from $81 million versus $60 million, according to Healthcare Products Information Services data. To put that in perspective: The growth rate for synthetic gloves is three times greater than that of powder-free latex gloves, the next closest segment at $7 million. Further, powdered latex sales were down more than $6 million to $67 million and it's predicted that, over the next two years, this segment will account for just 15 percent of the surgical glove market.

The newest offerings reflect these trends, as manufacturers spent the end of 2005 and, now, the beginning of 2006 introducing gloves that cater to users' shifting preferences. Here's a look at the options at hand.

The synthetics
There are two types of synthetics, polyisoprene and polychlorine. Manufacturers are working to improve gloves made with both materials in an effort to aid the move away from latex. As polyisoprene has the same chemical structure as latex (only it's synthesized in a lab, not in nature), it is generally considered the best synthetic alternative to latex. There are five new polyisoprene offerings.

Ansell DermaPrene PI Type: synthetic polyisoprene (800) 800-0445 www.ansellpro.com

DermaPrene PI from Ansell. This glove is thinner than Ansell's other offerings in this material, providing enhanced tactile sensitivity in the fingertips and enhancing ease and comfort of double-gloving, the company says. The DermaPrene PI features a smooth finish for "worry-free instrument and suture handling" and a light-green color "for instant latex-free identification," says the company. Further, the gloves are powder-free to help eliminate powder-related post-operative complications.

• Sensicare Green with Aloe from Medline. In response to an industry-wide shortage of polyisoprene, Medline is in the process of expanding its polyisoprene manufacturing plant to meet the growing demand for this material and to accommodate the launch of its new microthin glove, the Sensicare Green with Aloe, which is due by April. Ten percent thinner than the standard Sensicare, this version is "perfect for delicate procedures requiring more tactile sensitivity and when double-gloving," says Paul Bottcher, the vice president of Medline's surgical glove division.

He notes that the Sensicare Green with Aloe is ideally suited for procedures that require more sensitivity, such as ophthalmology, and that it can be used as a standard glove in lower-risk situations that do not require a standard-thickness glove. The glove also contains a pure aloe vera lining to prevent contact dermatitis.

ECI Medical Technologies Elastyfree/Syntegra (Sempermed private label) Type: synthetic polyisoprene (800) 668-5289 www.ecimedical.com

• Elastyfree/Syntegra from ECI Medical Technologies. In January, the company launched its improved styrene-isoprene-styrene-based latex-free, powder-free surgical glove, according to ECI president Keith Boulter.

"The new glove is dipped on a newly designed custom former and is significantly softer than previous versions, resulting in improved fit, feel and comfort without compromising strength," he says. In addition, the glove does not contain accelerator chemicals sometimes used in the manufacture of latex and polyisoprene gloves, which have been linked to reactions.

Barrier Med Barrier Plus Gold Surgical and Ortho Type: synthetic polyisoprene (800) 966-1604 www.barriermed.com

• Barrier Plus Gold Surgical from Barrier Med. This surgical glove, an update on the company's Barrier Poly Gold line, is a bit thicker (10 mils versus 9 mils) and much stronger than previous versions, says Michael Pavesi of Medrisk Solutions, which consults for Barrier Med. "Grip enhancement has been added to the outside coating, and the material itself actually establishes the grip," he says.
• Barrier Plus Gold Ortho from Barrier Med. The orthopedic version is 30 percent thicker (13.5 mils) and features better tensile strength; it is the first polyisoprene orthopedic glove, says Mr. Pavesi. Also on its way from Barrier Med is a polychloroprene update to the Barrier Plus Gold: the Barrier Plus Platinum, which is a testament to the strides the material is making as a latex alternative, the company says.

New in neoprene
The traditional view is that polychloroprene, known more commonly as chloroprene or neoprene, isn't as latex-like as polyisoprene. "Historically, neoprene latex-free gloves have been stiff, uncomfortable and often brittle," says Medline's Mr. Bottcher. "But when you consider that there is a worldwide shortage of polyisoprene, and surgical facilities still need a low-cost, latex-free alternative, the need for new neoprene gloves is very important."

Medline Neolon 2G Type: synthetic polychloroprene (800) MEDLINE www.medline.com

Neolon 2G from Medline. The second-generation Neolon 2G has a proprietary formulation that "has made for a softer and more elastic fit that is more comfortable than traditional neoprene," says Mr. Bottcher. Two cuff modifications also make the Neolon 2G more user-friendly: It's reinforced, to prevent gloves' tearing during donning, and it has been "short-dipped" to help prevent cuff roll-down. "We use a proprietary process that produces a reinforced cuff with a tacky surface that will grip the surgical gown better," says Mr. Bottcher.

Another bonus to keep in mind as neoprene develops is cost: "Compared to other latex-free gloves out there, neoprene is less expensive than polyisoprene," says Mr. Bottcher.

The naturals
Two new offerings in the latex category have been manufactured to prevent latex sensitization.

Ansell Gammex SureFit Type: powder-free latex (800) 800-0445 www.ansellpro.com

• Gammex SureFit from Ansell. This is a powder-free, general-purpose surgical glove "developed to overcome the problem of cuff roll-down experienced by OR personnel when wearing the new impervious surgical gowns," says the company. The glove's cuff grips and holds, says Ansell; in addition, Gammex SureFit is said to provide excellent fit and comfort, puncture resistance, tactile sensitivity and ease of donnability.

Regent Biogel Eclipse Type: deproteinised, powder-free latex (800) 805-0585 www.regentmedical.com

• Biogel Eclipse from Regent Medical. A deproteinised-latex, powder-free surgical glove, the Biogel Eclipse is different from a low-protein glove thanks to the company's specialized manufacturing process that leaves extractable latex proteins below detectable limits in the finished product.

"There are rubber-bound and water-bound proteins," says Carolyn Twomey, RN, the director of clinical affairs for Regent. "We have been very successful in reducing the aqueous proteins, and that's what you're measuring when you're measuring the residual proteins. When you measure against the testing standards that the FDA uses, the results show the protein level (in the Biogel Eclipse) as below detectable limits."

Still, the glove isn't 100 percent protein-free and therefore can't be used on patients and healthcare workers who are identified as latex-sensitive.

The company washes its gloves three times after vulcanization to reduce residual chemicals that can irritate skin. The Biogel Eclipse also is lined with company's patented moisturizing gel, which makes it less irritating, says Ms. Twomey.

"We're giving healthcare workers the ability to stay in a latex glove - because latex is the gold standard for performance, and it remains the choice of most practitioners," says Ms. Twomey. "But it's also an opportunity to potentially reduce the risk of latex sensitization without having to go synthetic."

Meeting the benchmark
"Latex is awesome as a benchmark for tensile strength, comfort, fit, feel and elongation," says Mr. Pavesi. The challenge for glove manufacturers, then, whether they're working with synthetics or latex, is to devise a safe, fully protein-free glove that still feels like latex.