title: Scalpel safety in the operative setting: a systematic review.
abstract: BACKGROUND
  The complex environment of the operative setting provides multiple opportunities for health care workers to sustain scalpel injuries; scalpels are the second most frequent source of sharps injuries in this setting. Little evidence has been published detailing the effectiveness of proposed safety procedures and devices.
  
  
  METHODS
  A systematic search strategy was used to identify relevant studies. Studies were included based on the application of a predetermined protocol, an independent assessment by 2 reviewers, and a consensus decision. Nineteen articles formed the evidence base for this review.
  
  
  RESULTS
  Little high-level evidence was available. The results of studies reporting on 5 different devices/procedures were identified: the use of cut-resistant gloves/liners decreased the number of glove perforations in comparison with double latex gloves alone but lessened the wearer's dexterity and tactile sensation; the benefit derived from the use of the hands-free passing technique seemed equivocal; "sharpless surgery" was found to be feasible; a single-handed blade remover prevented at least as many injuries as a safety scalpel; and some shoe materials provided superior foot protection.
  
  
  CONCLUSIONS
  The lack of available evidence highlights the need for the generation of a methodologically rigorous, clinically relevant, and statistically valid body of primary research in this area to support appropriate and effective safety interventions.
authors.affiliation: Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S), Royal Australasian College of Surgeons, Adelaide, Australia.
authors.forename: Amber M
authors.initials: AM
authors.lastname: Watt
authors.forename: Michael
authors.initials: M
authors.lastname: Patkin
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Sinnott
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Black
authors.forename: Guy J
authors.initials: GJ
authors.lastname: Maddern
mesh_terms: D000062:Accidents, Occupational / Q000517:prevention & control*; D006801:Humans; D009873:Operating Rooms; D011482:Protective Devices; D013525:Surgical Instruments / Q000009:adverse effects*