醫用手套面面觀

Aspects of Medical Gloves

醫用手套根據用途可分為「手術用手套」、「病人檢查用手套」，二者隨著用途不同，製作和包裝的細緻度也有差異。本文簡述手套的演變與由來，整理各材質特色和優劣，供單位選用和採購之參考；譬如乳膠手套彈性佳，但是，部分人長期穿戴會對其蛋白質成分發生過敏，且因不耐油的特性，勿使用油性護手產品。丁腈手套比較沒有蛋白質引起過敏的問題，但價位稍高。PVC（Polyvinyl Chloride）手套價格低，但含較高的增塑劑且不耐熱。PVC與乳膠不具有防靜電、抗酸鹼性能。文獻顯示含粉手套會有引起過敏的問題和影響傷口癒合，食品藥物管理署原訂2021年元旦起全面禁止輸入、製造，禁用含粉手套，未來無粉手套若被驗出粉量超標，將視為不良醫材，並明訂有罰則，不過，因新冠肺炎疫情衝擊國際醫材供應鏈，此政策暫緩，待疫情過後另訂實施期程。另外，也重申世界衛生組織強調使用手套時應遵循的規範，穿脫手套前後應執行手部衛生，手套不能取代洗手或刷手；照護不同病人或同一病人從污染的身體部位轉換到乾淨的部位或不同環境時，應手部衛生後更換手套。（感控雜誌2021:31:129-136）

Medical gloves are classified as "surgical gloves" and "patient examination gloves" depending on the purpose. Gloves vary in production and packaging based on the use. This article briefly describes the evolution and origin of gloves, tabulating the characteristics, advantages, and disadvantages of each material, for reference by the unit for selection and purchase. For example, latex gloves exhibit good elasticity. However, they cause allergic reactions in some people owing to the protein components when worn for a long time and are not oil-resistant, hindering the use of oily hand products. Nitrile gloves are relatively free of protein allergens but slightly expensive. Polyvinyl chloride and latex gloves do not exhibit antistatic properties or acid or alkali resistance. Previous studies showed that powder-containing gloves cause allergies and affect wound healing. The Taiwan Food and Drug Administration had stipulated that the import and manufacture of powder-containing gloves would be prohibited from January 1, 2021 and those of powder-free gloves would be penalized if the amount of powder detected exceeds the standard medical materials. However, due to the global coronavirus disease pandemic hampering the international medical supply chain, this policy was suspended. In addition, this article also reiterates World Health Organization’s emphasis on the rules underlying glove use, such as hand hygiene measures before and after putting on and taking off gloves. Wearing gloves cannot replace washing or scrubbing the hands. When caring for different patients or switching from a contaminated to a clean body part in the same patient or between environments, gloves should be replaced, and the hands should be washed.