An inability to detect a pulse is
the most common reported reason for not donning gloves. A study by Mylon et al. (2016) considered the effects of
gloves on pulse detection using a design whereby water is pumped through one of
five tubes under a layer of neoprene sponge using a peristaltic pump. They
found significant differences in ability to feel the ‘pulse’ in gloved and
ungloved conditions. The authors note that this cannot accurately simulate a
pulse test due to the pump limitations on the speed and pressure. Also, there
was the potential for bias due to the inability to vary the pulse location.
Using a pump to get to the same pressure and speed of blood would be more
simulative of the real world. Overall, most of studies go to show that tactile
sensitivity is reduced when gloves are worn, but the extent to which this
becomes a detriment to a patient is unknown.

 

1.        
Dexterity

Dexterity is defined as the
ability to carry out tasks using motor skill, moving the hands, fingers and
arms. The conformity of bending of the hands and fingers, material folding, and
thickness are the main areas affecting dexterity, (Dianat et al., 2012). Together these can affect the ability of surgeons to
carry out tasks and manipulate objects with fine skill. Numerous dexterity
tests have been developed, as shown in Table 2. Widely used in these studies,
are the Purdue Pegboard and the Crawford Small Parts Dexterity Test (CSPDT).
Described by (Tiffin and Asher 1948) the Purdue pegboard test is designed to assess
how many pegs can be placed into a board in the time set using both hands and
each hand separately. Washers can also be placed on the pegs in the test to
allow further assessments. The CSPDT test requires the placement of the pins
with the use of tweezers, assessing finer dexterity. The results generally show
that dexterity is affected when thicker or double gloves are worn (Moore et al., 1995; Chen et al., 1998; Pourmoghani, 2004;
Sawyer and Bennet, 2006 Gnaneswaran et
al., 2008; Berger et
al., 2009; Drabek
et al., 2009; Fry et al., 2010; Johnson et al., 2013; Mylon et al.,
2016 and Park et
al., 2016). Although not much
of a difference is observed. vinyl shows more of a decrease in dexterity whilst
latex shows minimal. Francis et al.
(2001) and Hamstra and Dubrowksi (2005) demonstrates the varied skill of
professionals is a factor. They found students has less dexterity and dropped
more pins than experienced surgeons. Gauvin et
al. (2006) states that these tests are of a good enough sensitivity to
measure performance difference and discriminate between gloves. However, there
are numerous issues with these tests. The primary issue being that the friction
of each person’s hand is different in the ‘no gloves’ variable due to sweat and
oils on the fingers. No mention of washing the pegs or hands is present in any
of the literature. Many of these studies include the NHS first choice gloves:
nitrile and latex as well as gloves that are not commonly used such as butyl
and Vinyl (Pratt et al., 2007).

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