1. Conclusions The results of most of these

1.        
Conclusions

The results of most of these
tests give the inference that medical gloves have a negative effect on tactile
sensitivity and user comfort. The research in this field appears to be trying
to compare glove materials to determine differentiating performance, rather
than assessing the effects gloves have overall. It can be argued that, as no
differences are present with latex and nitrile gloves there are no differences
in the overall effects on the user. However, research needs to be focused on
how to assess the gloves effectively to reduce the negative impact that a of
loss tactile sensation could have on patients. This review shows that further
work needs to be carried out whilst considering the specific nature of surgical
tasks. Many of the tests are carried out in basic laboratory conditions, such
as the SMETT tests in Mylon et al.
(2017). The studies do not consider the presence of slippery bodily fluids,
orientation of hand and other objects touching the hands which could impact
sensation in a medical practice. For example, if the hand is in a cavity and
the back of the hand in contact with an organ, does this impact sensitivity?
Similar tests to existing studies could be developed using different materials
and/or simulations (such as lacerations) that reflect the depth and feel of the
skin/tissues to have a more realistic view of the effect of gloves in surgical
environments. Further tests could then be developed such as digital image
correlation (DIC) tests could look at the strain that is put on the gloves and/or
hands during common surgical tasks. This could allow the development of gloves
with different material properties in different areas of the hand, e.g. loose
on the dorsal metacarpal to reduce strain. Orienting studies to fill the gaps,
such as more studies in friction and grip will improve the assessment of glove
materials. Tests should be blinded where possible to limit the psychological
‘status-quo’ bias that is evident in the literature. More computational models
could be adopted to assess medical gloves and their impact on healthcare. Zia, et al. (2017) assesses the quality and
efficiency of a surgeon’s stitches using a computational model that tracks the
work carried out. Adapting this technology to look at the quality and
efficiency using different glove types could prove beneficial. It is salient
that the effect gloves have on manual performance is determined to ensure
safety of the patient and the user. This assessment needs to be implanted at
the manufacturing process to allow an effective assessment of the glove
materials.

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