Glove Fit in Hand Brace Wearers 

The United States Centers for Disease Control and Prevention (CDC) provide no specific guidance related to wearing medical devices, such as thumb braces, on hands during patient treatment.¹ The size and fit of the brace as well as the material its made from require some considerations during patient treatment.

The CDC found that rings, decorative hand jewelry, and artificial nails provide more surface area for pathogens to colonize, posing a potential risk of contamination and impeding the wearing of correctly sized gloves.¹ Therefore, these practices should be avoided. In that vein, best practices suggest  the brace should not be worn during patient treatment when gloves are needed. A brace can be worn during break periods throughout the workday or at night while sleeping.² A study by Dydyk et al,² found that the nighttime use of braces, along with rest periods, is effective in reducing pain.

Braces help by immobilizing and protecting joints and can be composed of custom-fit thermoplastic, fiberglass, or prefabricated nylon with mesh and Velcro.³ Braces are often first line therapy to reduce pressure on injured joints and can help patients delay the need for surgery.²

Infection control measures will vary depending on the type of brace material. If braces must be worn during patient treatment, care must be taken to reduce the level of potential contamination, including proper hand hygiene and glove use, laundering, wiping the brace, or alternating braces.

Hand hygiene is the best method to prevent disease transmission.⁴ Hand hygiene should be performed before donning gloves and after doffing gloves because transient skin microorganisms thrive in a warm moist environment.¹ Depending on the style of brace, hand hygiene should be performed and then appropriately sized gloves donned under the brace with an additional larger glove covering the brace to avoid contamination.

Other suggestions include wiping the brace with an intermediate-level disinfectant after each use, laundering or alternating the brace, and designating one brace for home use and one  for patient treatment to reduce potential contamination.

Healthcare workers’ clothing can become contaminated and possibility transmit microorganisms.⁵ A fabric nylon mesh or Velcro thumb brace would fall under the category of clothing, thus requiring laundering. A plastic brace could be treated as a noncritical item or surface item and could be wiped with an intermediate level-disinfectant after each use. Careful attention to hand hygiene would be necessary when handling the brace designated for use during patient treatment.

Keep in mind, none of these suggestions is supported by guidance or evidence ; they are based on my own interpretation of best practices.

References

1. Koh WG, Collins AS, Cleveland JL, et al. Guidelines for infection control in dental healthcare settings 2003. MMWR Recomm Rep. 2003;52(RR-17):1-61.
2. Dydyk AM, Guillermo N, Gurpreet S, Cascella M. Median nerve injury. StatPearls. Available at: ncbi.nlm.nih.gov/books/NBK553109. Accessed February 26, 2024.
3. Sprouse RA, McLaughlin AM, Harris GD. Braces and splints for common musculoskeletal conditions. Am Fam Physician. 2018;15: 570-576.
4. United States Centers for Disease Control and Prevention. Summary of Infection Prevention Practices in Dental Settings. Basic Expectations for Safe Care. Available at: cdc.gov/oralhealth/infectioncontrol/pdf/safe-care2.pdf. Accessed February 26, 2024.
5. Infectious Disease Advisor. Bare below the elbow and implications for infection control. Available at: infectiousdiseaseadvisor.com/home/decision-support-in-medicine/hospital-infection-control/bare-below-the-elbow-and-implications-for-infection-control. Accessed February 26, 2026.

From Dimensions of Dental Hygiene. March 2024; 22(2):46