title: Blunt versus sharp suture needles for preventing percutaneous exposure incidents in surgical staff.
abstract: BACKGROUND
  Surgeons and their assistants are especially at risk of exposure to blood due to glove perforations and needle stick injuries during operations. The use of blunt needles can reduce this risk because they don't penetrate skin easily but still perform sufficiently in other tissues.
  
  
  OBJECTIVE
  To determine the effectiveness of blunt needles compared to sharp needles for preventing percutaneous exposure incidents among surgical staff.
  
  
  METHODS
  We searched MEDLINE and EMBASE (until May 2011), CENTRAL, NHSEED, Science Citation Index Expanded, CINAHL, Nioshtic, CISdoc, PsycINFO, and LILACS (until September 2010).
  
  
  METHODS
  Randomised controlled trials (RCTs) of blunt versus sharp suture needles for preventing needle stick injuries among surgical staff measured as glove perforations or self-reported needle stick injuries.
  
  
  METHODS
  Two authors independently assessed study eligibility and risk of bias in trials and extracted data. We synthesized study results with a fixed-effect model meta-analysis.
  
  
  RESULTS
  We located 10 RCTs involving 2961 participating surgeons performing an operation in which the use of blunt needles was compared to the use of sharp needles. Four studies focused on abdominal closure, two on caesarean section, two on vaginal repair and two on hip replacement. On average, a surgeon that used sharp needles sustained one glove perforation in three operations. The use of blunt needles reduced the risk of glove perforations with a relative risk (RR) of 0.46 (95% confidence interval (CI) 0.38 to 0.54) compared to sharp needles. The use of blunt needles will thus prevent one glove perforation in every six operations.In four studies, the use of blunt needles reduced the number of self-reported needle stick injuries with a RR of 0.31 (95% CI 0.14 to 0.68). Because the force needed for the blunt needles is higher, their use was rated as more difficult but still acceptable in five out of six studies.The quality of the evidence was rated as high.
  
  
  CONCLUSIONS
  There is high quality evidence that the use of blunt needles appreciably reduces the risk of exposure to blood and bodily fluids for surgeons and their assistants over a range of operations. It is unlikely that future research will change this conclusion.
authors.affiliation: Health Care and Social Services, Finnish Institute of Occupational Health, Turku, Finland. annika.parantainen@ttl.fi
authors.forename: Annika
authors.initials: A
authors.lastname: Parantainen
authors.forename: Jos H
authors.initials: JH
authors.lastname: Verbeek
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Lavoie
authors.forename: Manisha
authors.initials: M
authors.lastname: Pahwa
mesh_terms: D004867:Equipment Design; D013502:General Surgery; D005932:Gloves, Surgical; D006801:Humans; D009339:Needles; D016602:Needlestick Injuries / Q000517:prevention & control*; D016273:Occupational Exposure / Q000517:prevention & control*; D009873:Operating Rooms; D013536:Suture Techniques / Q000295:instrumentation*
references.citation: J Obstet Gynaecol. 2002 Jan;22(1):75-8
references.pmid: 12521735
references.citation: AORN J. 2011 Mar;93(3):322-30
references.pmid: 21353803
references.citation: East Afr Med J. 2002 May;79(5):254-6
references.pmid: 12638809
references.citation: Cochrane Database Syst Rev. 2017 Nov 14;11:CD009740
references.pmid: 29190036
references.citation: Ann R Coll Surg Engl. 2007 Apr;89(3):276-80
references.pmid: 17394714
references.citation: BMJ. 2008 May 10;336(7652):1031
references.pmid: 18467382
references.citation: J Infect Public Health. 2008;1(2):62-71
references.pmid: 20701847
references.citation: World J Surg. 1998 Oct;22(10):1092-7
references.pmid: 9747173
references.citation: Cochrane Database Syst Rev. 2005 Oct 19;(4):CD000100
references.pmid: 16235273
references.citation: Am J Infect Control. 2002 Jun;30(4):207-16
references.pmid: 12032495
references.citation: Ann R Coll Surg Engl. 1994 Jul;76(4):281
references.pmid: 8074393
references.citation: Obstet Gynecol. 2009 Aug;114(2 Pt 1):211-216
references.pmid: 19622979
references.citation: Am J Infect Control. 2002 Aug;30(5):283-7
references.pmid: 12163862
references.citation: Cochrane Database Syst Rev. 2004 Oct 18;(4):CD004663
references.pmid: 15495122
references.citation: Occup Environ Med. 2005 Oct;62(10):682-7
references.pmid: 16169913
references.citation: Surg Clin North Am. 2005 Dec;85(6):1299-305, xiii
references.pmid: 16326210
references.citation: Am J Ind Med. 1996 Apr;29(4):303-7
references.pmid: 8728129
references.citation: Infect Control Hosp Epidemiol. 2008 Dec;29(12):1139-48
references.pmid: 18991506
references.citation: World J Surg. 2005 Apr;29(4):441-5; discussion 445
references.pmid: 15776298
references.citation: Zentralbl Chir. 1996;121(1):30-4
references.pmid: 8852738
references.citation: J Hosp Infect. 2005 Jul;60(3):269-75
references.pmid: 15949619
references.citation: J Obstet Gynaecol. 1998 Jan;18(1):18-9
references.pmid: 15511994
references.citation: Br J Surg. 1996 Aug;83(8):1156-7
references.pmid: 8869333
references.citation: Int J Epidemiol. 2002 Feb;31(1):150-3
references.pmid: 11914311
references.citation: Spine (Phila Pa 1976). 2009 Aug 15;34(18):1929-41
references.pmid: 19680101
references.citation: Obstet Gynecol. 2007 Dec;110(6):1399-403
references.pmid: 18055739
references.citation: Clin Infect Dis. 2003 Oct 15;37(8):1006-13
references.pmid: 14523763
references.citation: J Prof Nurs. 2006 Nov-Dec;22(6):359-66
references.pmid: 17141720
references.citation: Cochrane Database Syst Rev. 2021 Apr 14;4:CD012060
references.pmid: 33871067
references.citation: J Obstet Gynaecol. 1998 Sep;18(5):478-9
references.pmid: 15512148
references.citation: Infect Control Hosp Epidemiol. 1999 Feb;20(2):110-4
references.pmid: 10064214
references.citation: Surgery. 2010 Jan;147(1):98-106
references.pmid: 19828169
references.citation: J Am Coll Surg. 1994 Feb;178(2):107-10
references.pmid: 8173718
references.citation: J Hosp Infect. 2006 Sep;64(1):44-9
references.pmid: 16835002
references.citation: Surg Gynecol Obstet. 1991 Aug;173(2):147-8
references.pmid: 1833840
references.citation: AIHA J (Fairfax, Va). 2003 Jan-Feb;64(1):62-7
references.pmid: 12570397
references.citation: BMJ. 1988 Nov 5;297(6657):1193
references.pmid: 3144347
references.citation: J Am Coll Surg. 2008 Jan;206(1):113-22
references.pmid: 18155576
references.citation: J Bone Joint Surg Br. 1993 Nov;75(6):918-20
references.pmid: 8245082
references.citation: Int Orthop. 1996;20(3):132-3
references.pmid: 8832312
references.citation: Am J Ind Med. 2005 Dec;48(6):482-90
references.pmid: 16299710
references.citation: Am J Infect Control. 2006 Aug;34(6):376-82
references.pmid: 16877107
references.citation: Am J Obstet Gynecol. 1996 Oct;175(4 Pt 1):862-6
references.pmid: 8885737
references.citation: Cochrane Database Syst Rev. 2011 Nov 09;(11):CD009170
references.pmid: 22071864
references.citation: Br J Surg. 1988 Apr;75(4):317
references.pmid: 2451967
references.citation: Am J Obstet Gynecol. 2008 Dec;199(6):641.e1-3
references.pmid: 18639205
references.citation: Cochrane Database Syst Rev. 2014 Mar 07;(3):CD009573
references.pmid: 24610769
references.citation: J Long Term Eff Med Implants. 2003;13(1):1-10
references.pmid: 12825744
references.citation: Am J Surg. 1996 Nov;172(5):512-6; discussion 516-7
references.pmid: 8942555
references.citation: J Adv Nurs. 2006 Dec;56(5):563-8
references.pmid: 17078831
references.citation: Infect Control Hosp Epidemiol. 2007 Jan;28(1):10-7
references.pmid: 17230382
references.citation: J Occup Health. 2006 Nov;48(6):474-9
references.pmid: 17179640
references.citation: Braz J Infect Dis. 1999 Apr;3(2):50-62
references.pmid: 11098192