What is the Difference Between Surgical Gloves and Nitrile Gloves? (2023)

Nitrile vs Latex Gloves - What's the Difference

If you need to buy new gloves, you might wonder if you should purchasenitrileor latex gloves.

What Are Latex Gloves?

Latex gloves fit hands like a second skin, which gives them tactile sensitivity and dexterity.

The above point makes them valuable for use in sensitive and precise applications, such as surgery.

They are usually lightly powdered, and this makes them easier to put on and take off.

They are very elastic, and that increases their level of strength.

Cons

Since latex gloves are powdered, this can cause allergic reactions in some people.

Latex in general is an allergen, which can make it dangerous to use when it comes to healthcare settings.

Due to their color and how they’re like a second skin, latex gloves can make it difficult for you to detect tears and punctures in them.

Latex gloves do not handle chemicals and solvents very well, offering minimal protection against them.

What Are Nitrile Gloves?

Nitrile gloves are extremely strong and durable, while being resistant to punctures and tears.

These gloves come in a variety of colors so that it makes it easier to notice if they have tears in them. Their colors can also help to conceal substances that could be on them, such as tattoo ink or blood.

Nitrile gloves are highly resistant to chemicals and solvents.

Medical-grade gloves are usually made out of nitrile because this material is resistant to fats and oils in the body.

Since they don’t contain any latex, nitrile gloves are safe for people who have latex allergies. This is especially beneficial because some allergic reactions to latex can be life-threatening. An example is anaphylaxis.

Cons

Nitrile gloves tend to be a bit more expensive than latex gloves.

These gloves are not as comfortable as compared to latex gloves. This is something to bear in mind if you need to wear the gloves for long periods of time.

Nitrile is said to have less tensile strength than other glove materials, such as latex. Tensile strength is the load that a material can tolerate before cracking or breaking. That said, nitrile still offers excellent protection against tears, cuts, and punctures.

Medical glove

Single-use glove worn during medical examinations and procedures

Dentist wearing nitrile gloves

Medical gloves are disposable gloves used during medical examinations and procedures to help prevent cross-contamination between caregivers and patients.[1] Medical gloves are made of different polymers including latex, nitrile rubber, polyvinyl chloride and neoprene; they come unpowdered, or powdered with corn starch to lubricate the gloves, making them easier to put on the hands.[2]

Corn starch replaced tissue-irritating lycopodium powder and talc, but even corn starch can impede healing if it gets into tissues (as during surgery). As such, unpowdered gloves are used more often during surgery and other sensitive procedures. Special manufacturing processes are used to compensate for the lack of powder.

There are two main types of medical gloves: examination and surgical. Surgical gloves have more precise sizing with a better precision and sensitivity and are made to a higher standard. Examination gloves are available as either sterile or non-sterile, while surgical gloves are generally sterile.[3]

Besides medicine, medical gloves are widely used in chemical and biochemical laboratories. Medical gloves offer some basic protection against corrosives and surface contamination. However, they are easily penetrated by solvents and various hazardous chemicals, and should not be used for dishwashing or otherwise when the task involves immersion of the gloved hand in the solvent.

Medical gloves are recommended to be worn for two main reasons:[4]

To reduce the risk of contamination of health-care workers hands with blood and other body fluids.

To reduce the risk of germ dissemination to the environment and of transmission from the health-care worker to the patient and vice versa, as well as from one patient to another.

History

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Caroline Hampton became the chief nurse of the operating room when Johns Hopkins Hospital opened in 1889.[5] When "[i]n the winter of 1889 or 1890" she developed a skin reaction to mercuric chloride that was used for asepsis, William Halsted, soon-to-be her husband, asked the Goodyear Rubber Company to produce thin rubber gloves for her protection.[5] In 1894 Halsted implemented the use of sterilized medical gloves at Johns Hopkins.[6][7] However, the first modern disposable glove was invented by Ansell Rubber Co. Pty. Ltd. in 1965.[8][9][10]

They based the production on the technique for making condoms.[11] These gloves have a range of clinical uses ranging from dealing with human excrement to dental applications.[citation needed]

Criminals have also been known to wear medical gloves during commission of crimes. These gloves are often chosen because their thinness and tight fit allow for dexterity. However, because of the thinness of these gloves, fingerprints may actually pass through the material as glove prints, thus transferring the wearer's prints onto the surface touched or handled.[12]

The participants of the Watergate burglaries infamously wore rubber surgical gloves in an effort to hide their fingerprints.[13]

Industry

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In 2020, the market for medical gloves had a value of more than USD 10.17 billion and, with growing demand (especially in developing countries), is expected to grow by 9.2 per cent per year until 2028.[14] The majority of medical gloves is manufactured in South East Asia with Malaysia alone accounting for about three quarters of global production in 2020.[15]

Labour rights violations

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There have been several investigations in factories in Malaysia, Thailand and Sri Lanka that documented severe violations of human and labour rights. Both in Malaysia and Thailand migrants represent the majority of workers in hard physical labour. They are frequently recruited by specialized agencies in their less affluent home countries such as Nepal and are often charged with high recruitment fees forcing them into debt bondage. There are documented cases in which employees' passports were withheld by their employers leaving them especially vulnerable to exploitation.[16][17] In 2010, for instance, Swedwatch, a Swedish labour right NGO examining a Malaysian factory, reported that most employees were working 12 hours per day seven days a week without overtime pay or payslip, harassment of workers by the management, safety deficits and poor hygienic conditions in employee housing.[18] [16] Reacting to these findings, from October 2019 to March 2020, the US Department of Labor listed medical gloves produced in Malaysia on the List of Goods Produced by Child Labor or Forced Labor and temporarily banned the import of gloves produced by the Malaysian company Top Glove, the world's largest manufacturer at the time.[19] [20]

Sizing

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Generally speaking, examination gloves are sized in XS, S, M and L. Some brands may offer size XL. Surgical gloves are usually sized more precisely since they are worn for a much longer period of time and require exceptional dexterity. The sizing of surgical gloves are based on the measured circumference around the palm (excluding the thumb) in inches, at a level slightly above the thumb's sewn. Typical sizing ranges from 5.5 to 9.0 at an increment of 0.5. Some brands may also offer size 5.0. First-time users of surgical gloves may take some time to find the right size and brand that suit their hand geometry the most.[21] People with a thicker palm may need a size larger than the measurement and vice versa. Sizing should be one of the first thing to look for. Dexterity is essential for every worker and wearing the wrong size of glove can have a huge impact on someone's work. Wearing the right size of glove can also increase comfort, which can influence workers to wear their assigned PPE.[22]

Research on a group of American surgeons found that the most common surgical glove size for men is 7.0, followed by 6.5; and for women 6.0 followed by 5.5.[23]

Powdered gloves

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To facilitate donning of gloves, powders have been used as lubricants. Early powders derived from pines or club moss were found to be toxic.[24] Talcum powder was used for decades but linked to postoperative granuloma and scar formation. Corn starch, another agent used as lubricant, was also found to have potential side effects such as inflammatory reactions and granuloma and scar formation.[24]

Elimination of powdered medical gloves

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With the availability of non-powdered medical gloves that were easy to don, calls for the elimination of powdered gloves became louder. By 2016, healthcare systems in Germany and the United Kingdom had eliminated their use.[24] In March 2016, the United States Food and Drug Administration (FDA) issued a proposal to ban their medical use[25] and on December 19, 2016 passed a rule banning all powdered gloves intended for medical use.[26] The rule became effective on January 18, 2017.[27]

Powder-free medical gloves are used in medical cleanroom environments, where the need for cleanliness is often similar to that in a sensitive medical environment.[citation needed]

Chlorination

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To make them easier to don without the use of powder, gloves can be treated with chlorine. Chlorination affects some of the beneficial properties of latex, but also reduces[28] the quantity of allergenic latex proteins.[29]

Polymer coating

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On the market, it is a wide range of applications for polymer coatings in the market. Most of the current disposable gloves are powdered. These coatings include several polymers: silicone, acrylic resins, and gels that make gloves easier to wear. This process is currently used in nitrile gloves and latex gloves.[30]

Alternatives to latex

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Nitrile powder free gloves

Due to the increasing rate of latex allergy among health professionals [31][citation needed], and in the general population, gloves made of non-latex materials such as polyvinyl chloride, nitrile rubber, or neoprene have become widely used. Chemical processes may be employed to reduce the amount of antigenic protein in Hevea latex, resulting in alternative natural-rubber-based materials such Vytex Natural Rubber Latex. However, non-latex gloves have not yet replaced latex gloves in surgical procedures, as gloves made of alternative materials generally do not fully match the fine control or greater sensitivity to touch available with latex surgical gloves.[citation needed] (High-grade isoprene gloves are the only exception to this rule, as they have the same chemical structure as natural latex rubber. However, fully artificial polyisoprene—rather than "hypoallergenic" cleaned natural latex rubber[32]—is also the most expensive natural latex substitute available.[33]) Other high-grade non-latex gloves, such as nitrile gloves, can cost over twice the price of their latex counterparts, a fact that has often prevented switching to these alternative materials in cost-sensitive environments, such as many hospitals.[citation needed] Nitrile is more resistant to tearing than natural latex, and is more resistant to many chemicals.[34] Sulfur compounds used as accelerants to cure nitrile can speed the tarnishing process in silver, so accelerant-free nitrile or other gloves must be used when handling objects made of these metals when this is not acceptable.[34]

Double gloving

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Double gloving is the practice of wearing two layers of medical gloves to reduce the danger of infection from glove failure or penetration of the gloves by sharp objects during medical procedures. Surgeons double glove when operating on individuals bearing infectious agents such as HIV and hepatitis, and to better protect patients against infections possibly transmitted by the surgeon. A systematic review of the literature has shown double gloving to offer significantly more protection against inner glove perforation in surgical procedures compared to the use of a single glove layer. But it was unclear if there was better protection against infections transmitted by the surgeon.[35] Another systematic review studied if double gloving protected the surgeon better against infections transmitted by the patient. Pooled results of 12 studies (RCTs) with 3,437 participants showed that double gloving reduced the number of perforations in inner gloves with 71% compared to single gloving. On average ten surgeons/nurses involved in 100 operations sustain 172 single gloves perforations but with double gloves only 50 inner gloves would be perforated. This is a considerable reduction of the risk.[36]

In addition, cotton gloves can be worn under the single-use gloves to reduce the amount of sweat produced when wearing these gloves for a long period of time. These under gloves can be disinfected and used again.[37]

References

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Exam Gloves vs. Surgical Gloves: What's the Difference?

Doctors, nurses, caregivers, dentists and other healthcare workers typically use examination gloves. The risk of the job should be taken into account when deciding between latex, vinyl and nitrile exam gloves. Latex and nitrile gloves are commonly used when dealing with high-risk situations involving blood, bodily fluids or patients with infectious diseases. Both latex and vinyl gloves can be used for low-risk, general procedures such as a non-invasive physical exam. Surgical gloves are higher quality and designed specifically for the accuracy and sensitivity required by surgeons.

Sterile vs. Non-Sterile Gloves

Sterile gloves are used primarily for surgical purposes. Sterile gloves must meet FDA standards based on an acceptable quality level of pinholes. Sterile gloves have a lower acceptable quality level compared to non-sterile gloves. Due to the stricter standards, sterile gloves are more expensive than non-sterile gloves. Studies show that in non-surgical procedures, there is no link between using non-sterile gloves and increased rates of infection. Therefore, most healthcare workers opt for non-sterile gloves for non-surgical procedures.

Does Glove Color Matter?

While usually a matter of preference, color can be of some importance. Some practices or hospitals using different types of gloves may purchase different colors so they are easily identifiable. This can be beneficial to those with a latex allergy.

Color can also be significant to some surgeons who double-glove. Double gloving is the practice of wearing a second pair of gloves over the first, as research shows this may help protect the first pair from damage. By wearing a light colored glove underneath a dark colored glove, or vice-versa, tears or punctures can be more readily identified when double gloving.

Powder vs. Powder Free Gloves

Cornstarch is used in powdered gloves which makes it easier to slip the glove over the hand. Powder from gloves can be an issue if it gets into wounds or exposed body tissue during a surgery as it can slow down the healing process. This is the reason most surgical procedures require powder free gloves, and manufacturers now use special processes to give them the same easy on/off properties of powdered gloves.

Latex Gloves

Advantages Disadvantages Comfort and dexterity Risk of allergic reaction to natural rubber Easy to put on, greater flexibility Thinner gloves cause more pinholes and tearing Polymer coating replaces corn starch powders Dissolves when in contact with oils, grease and other hydrocarbons Best fit, comfort, and flexibility Effective barrier against biological contaminants

Latex Gloves

Sets the standard for great fit and comfort

Flexible- available for use in exam and sterile surgical applications

High level of sensitivity

Durable / high strength

Mid-level barrier protection

Not suitable for those with latex allergies

Can cause the development of latex allergy when used often

Nitrile Gloves

Advantages Disadvantages No allergic reaction to natural rubber Dissolves when in contact with acetone Improved polymer technology creating a more comfortable fit Powdered versus Powder-Free Increased demand and manufacturing methods making it more affordable Best puncture and abrasion resistance Great latex alternative for individuals with allergies

Nitrile

Stronger than vinyl or latex

For use in examination applications

Available in sterile or non-sterile

Greater protection from chemical exposure

Protein and latex free

High-level barrier protection

Vinyl Gloves

Advantages Disadvantages Most cost-effective choice for small medical offices Frequent glove changes are required and a basic barrier will suffice. Great for short-term jobs where comfort is not a concern Vinyl gloves have the lowest puncture and chemical resistances. Vinyl gloves are less elastic than latex and nitrile, so when you choose this type, you sacrifice comfort and fit.

Vinyl Gloves

Economical, low cost

For use in examination applications only

Less durable- more likely to tear or be punctured

Standard-level barrier protection

Latex free for those with allergies

Made from polyvinyl chloride

Glove Sizes

Glove sizes vary by manufacturer and glove type. You should always make sure your glove is a good fit and comfortable to work in. It is best to consult the manufacturer prior to purchasing. Often times, the manufacturer will have a size chart available on their website.

That said, manufacturers have made advancements to improve the fit and feel of vinyl gloves, which has allowed multiple generations of them to exist in the market. For example, 3G vinyl (a patented third-generation stretch vinyl) is the most advanced to date.