What type of gloves are recommended for per rectal (per rectal examination) examinations?

Glove Recommendations for Per Rectal Examination

Use clean, non-sterile medical examination gloves (latex, nitrile, or neoprene) for routine digital rectal examination, with a new pair for each patient. 1, 2

Glove Type Selection

Non-Sterile Examination Gloves Are Appropriate

• Medical examination gloves provide adequate barrier protection for diagnostic procedures involving mucous membrane contact without tissue penetration. 2
• The CDC recommends wearing medical gloves whenever there is potential contact with mucous membranes, which includes rectal examination. 1, 2
• Sterile surgeon's gloves are specifically indicated only for surgical procedures that involve tissue invasion or entry into normally sterile body spaces, not for routine digital rectal examination. 1, 2

Material Selection Considerations

• Nitrile gloves demonstrate superior barrier effectiveness compared to vinyl or copolymer gloves, with failure rates of only 1.3% versus 8.2% for vinyl. 3
• Latex gloves provide excellent barrier protection (2.2% failure rate) but require screening for latex allergy in both patients and healthcare workers. 1, 3
• Nitrile gloves are 3 times less likely to fail than latex gloves and 12 times less likely to fail than vinyl gloves during simulated use conditions. 3
• In the presence of microperforation, latex gloves demonstrate 10-fold lower bacterial passage compared to nitrile or neoprene due to superior elasticity, though nitrile remains an acceptable alternative. 4
• Avoid vinyl gloves for procedures with potential bloodborne pathogen exposure, as they demonstrate failure rates of 12-61% during simulated use. 5

Essential Infection Control Protocol

Hand Hygiene Requirements

• Perform hand hygiene immediately before donning gloves for the rectal examination. 2
• Wash hands immediately after removing gloves to prevent transfer of microorganisms to other patients or environments. 1, 2

Single-Use Glove Policy

• Use a new pair of medical gloves for each patient and remove them promptly after the examination. 1, 2
• Never reuse, wash, disinfect, or attempt to sterilize examination gloves, as washing may cause "wicking" (penetration of liquids through undetected holes). 1, 2
• Remove and replace gloves immediately if they become torn, cut, or punctured during the examination. 1, 2

Glove Fit and Accessibility

• Ensure that appropriate gloves in the correct size are readily accessible to prevent compromised fit and integrity. 1
• Do not wear hand or nail jewelry if it makes donning gloves more difficult or compromises glove integrity. 1
• Keep fingernails short with smooth, filed edges to prevent glove tears. 1

When Sterile Gloves ARE Required

• Use sterile gloves for transrectal surgical procedures, such as transrectal prostate biopsy, not for routine digital rectal examination. 2

Double Gloving Considerations

• Double gloving is not routinely recommended for digital rectal examination. 1
• Double gloving is indicated for high-risk surgical procedures, emergency operations, and patients with known or suspected HIV or hepatitis B infection. 6
• Several endoscopy societies recommend double gloving for colonoscopy during COVID-19 pandemic conditions due to potential fecal-oral transmission risk. 1

Common Pitfalls to Avoid

• Do not use vinyl or polyethylene gloves for rectal examination, as they provide inadequate barrier protection with failure rates up to 61%. 5, 7
• Do not apply oil-based lotions or petroleum-based lubricants before gloving, as these can compromise glove integrity. 1
• Do not reuse gloves between patients under any circumstances, even if they appear intact. 1
• Ensure latex-safe alternatives (nitrile or neoprene) are available for patients and healthcare workers with documented latex allergy. 1