Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2011 Nov 9;2011(11):CD009170.
doi: 10.1002/14651858.CD009170.pub2.

Blunt versus sharp suture needles for preventing percutaneous exposure incidents in surgical staff

Annika Parantainen  1 , Jos H Verbeek, Marie-Claude Lavoie, Manisha Pahwa
Affiliations
Meta-Analysis

Blunt versus sharp suture needles for preventing percutaneous exposure incidents in surgical staff

Annika Parantainen et al. Cochrane Database Syst Rev. .

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.

Objectives: To determine the effectiveness of blunt needles compared to sharp needles for preventing percutaneous exposure incidents among surgical staff.

Search methods: We searched MEDLINE and EMBASE (until May 2011), CENTRAL, NHSEED, Science Citation Index Expanded, CINAHL, Nioshtic, CISdoc, PsycINFO, and LILACS (until September 2010).

Selection criteria: 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.

Data collection and analysis: 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.

Main 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.

Authors' 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.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interests.

Figures

1
1
Study flow diagram.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
4
4
Forest plot of comparison: 1 Blunt versus sharp suture needles, outcome: 1.1 Glove perforation rate.
5
5
Funnel plot of comparison: 1 Blunt versus sharp suture needles, outcome: 1.1 Glove perforation rate.
1.1
1.1. Analysis
Comparison 1 Blunt versus sharp suture needles, Outcome 1 Glove perforation rate.
1.2
1.2. Analysis
Comparison 1 Blunt versus sharp suture needles, Outcome 2 Needle Stick Injuries.
1.3
1.3. Analysis
Comparison 1 Blunt versus sharp suture needles, Outcome 3 Ease of use of Needle.
1.4
1.4. Analysis
Comparison 1 Blunt versus sharp suture needles, Outcome 4 Ease of use of needle.
1.5
1.5. Analysis
Comparison 1 Blunt versus sharp suture needles, Outcome 5 Force needed.
1.6
1.6. Analysis
Comparison 1 Blunt versus sharp suture needles, Outcome 6 Sensitivity to ROB.
1.7
1.7. Analysis
Comparison 1 Blunt versus sharp suture needles, Outcome 7 Subgroups Type of Operation.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD009170

References

References to studies included in this review

Ablett 1998 {published data only}
    1. Ablett JC, Whitten M, Smith JR. Do blunt tipped needles reduce the risk of glove puncture and needlestick injury in the suture of episiotomy and perineal repair?. Journal of Obstetrics and Gynaecology 1998;18(5):478‐9. - PubMed
Hartley 1996 {published data only}
    1. Hartley JE, Ahmed S, Milkins R, Naylor G, Monson JR, Lee PW. Randomized trial of blunt‐tipped versus cutting needles to reduce glove puncture during mass closure of the abdomen. British Journal of Surgery 1996;83:156‐7. - PubMed
Meyer 1996 {published data only}
    1. Meyer D, Hamelmann GW, Timmermann W, Thiede A. The risk of needlestick injuries during abdominal closure. Zentralblatt für Chirurgie 1996;121:30‐4. - PubMed
Mingoli 1996 {published data only}
    1. Mingoli A, Sapienza P, Sgarzini G, Luciani G, Angelis G, Modini C, et al. Influence of blunt needles on surgical glove perforation and safety for the surgeon. The American Journal of Surgery 1996;172(5):512‐7. - PubMed
Nordkam 2005 {published data only}
    1. Nordkam RAG, Bluyssen SJM, Goor H, Millat B. Randomized clinical trial comparing blunt tapered and standard needles in closing abdominal fascia. World Journal of Surgery 2005;29(4):441‐5. - PubMed
Rice 1996 {published data only}
    1. Rice JJ, McCabe JB, McManus F. Needle stick injury. Reducing the risk. International Orthopaedics 1996;20:132‐3. - PubMed
Sullivan 2009 {published data only}
    1. Sullivan S, Williamson B, Wilson LK, Korte JE, Soper D. Blunt needles for the reduction of needlestick injuries during cesarean delivery: a randomized controlled trial. Obstetrics and Gynecology 2009;114(2 Pt 1):211‐6. [MEDLINE: ] - PubMed
Thomas 1995 {published data only}
    1. Thomas PB, Falder S, Jolly M, Saunders NJG, Smith JR. The role of blunt tipped needles and a new needleholder in reducing needlestick injury. Journal of Obstetrics and Gynaecology 1995;15:336‐8.
Wilson 2008 {published data only}
    1. Wilson LK, Sullivan S, Goodnight W, Chang EY, Soper D. The use of blunt needles does not reduce glove perforations during obstetrical laceration repair. American Journal of Obstetrics and Gynecology 2008;199:639.e1‐9.e4. - PubMed
Wright 1993 {published data only}
    1. Wright KU, Moran CG, Briggs PJ. Glove perforation during hip arthroplasty. A randomised prospective study of a new taperpoint needle. Journal of Bone and Joint Surgery 1993;75‐B(6):918‐20. - PubMed

References to studies excluded from this review

Bebbington 1996 {published data only}
    1. Bebbington MW, Treissman MJ. The use of a surgical assist device to reduce glove perforations in postdelivery vaginal repair: A randomized controlled trial. American Journal of Obstetrics and Gynecology 1996;175(4):862‐6. - PubMed
Botet 1998 {published data only}
    1. Botet X, Serra J, Padrós R, López S, Boldó E, Llauradó JM, et al. Efficacy of PdB in preventing intraoperative risk of infectious diseases. World Journal of Surgery 1998;22:1092‐7. - PubMed
Monz 1991 {published data only}
    1. Monz FJ, Fowler JM, Farias‐Eisner R, Nash TJ. Blunt needles in fascial closure. Surgery, Gynecology & Obstetrics 1991;173:147‐8. - PubMed
Tydeman 1995 {published data only}
    1. Tydeman GSJ. Risks to surgeons: a comparison of blunt and sharp tipped suture needles. Journal of Obstetrics and Gynaecology 1995;15:333‐5.

Additional references

ACS 2011
    1. American College of Surgeons. Statement on sharps safety. Statements of the College 2011.
Akduman 1999
    1. Akduman D, Kim LE, Parks RL, L'Ecuyer PB, Mutha S, Jeffe DB, et al. Use of personal protective equipment and operating room behaviors in four surgical subspecialties: personal protective equipment and behaviors in surgery. Infection Control and Hospital Epidemiology 1999;20(2):110‐4. - PubMed
Anderson 2008
    1. Anderson ER, Gates S. Techniques and materials for closure of the abdominal wall in caesarean section. Cochrane Database of Systematic Reviews 2008, Issue 4. [DOI: 10.1002/14651858.CD004663.pub2] - DOI - PMC - PubMed
Ansa 2002
    1. Ansa VO, Udoma EJ, Umoh MS, Anah MU. Occupational risk of infection by human immunodeficiency and hepatitis B viruses among health workers in south‐eastern Nigeria. East African Medical Journal 2002;79(5):254‐6. - PubMed
Bennett 1994
    1. Bennett NT, Howard RJ. Quantity of blood inoculated in a needlestick injury from suture needles. Journal of the American College of Surgeons 1994;178(2):107‐110. - PubMed
Berguer 2005
    1. Berguer R, Heller PJ. Strategies for preventing sharps injuries in the operating room. Surgical Clinics of North America 2005;85:1299‐305. - PubMed
Brough 1988
    1. Brough SJ, Hunt TM, Barrie WW. Surgical glove perforations. British Journal of Surgery 1988;75:317. - PubMed
Catanzarite 2007
    1. Catanzarite V, Byrd K, McNamara M, Bombard A. Peventing needlestick injuries in obstetrics and gynecology. Obstetrics and Gynecology 2007;110(6):1399‐1403. - PubMed
Cheetham 2016
    1. Cheetham S, Thompson SC, Liira J, Afilaka OA, Liira H. Education and training for preventing sharps injuries and splash exposures in healthcare workers. Cochrane Database of Systematic Reviews 2016, Issue 1. [DOI: 10.1002/14651858.CD012060] - DOI - PMC - PubMed
Chen 2005
    1. Chen W, Gluud C. Vaccines for preventing hepatitis B in health‐care workers. Cochrane Database of Systematic Reviews 2005, Issue Issue 4. [DOI: 10.1002/14651858.CD000100.pub3] - DOI - PubMed
Clarke 2002
    1. Clarke SP, Rockett JL, Sloane DM, Aiken LH. Organizational climate, staffing, and safety equipment as predictors of needlestick injuries and near‐misses in hospital nurses. American Journal of Infection Control 2002;30(4):207‐16. - PubMed
Doebbeling 2003
    1. Doebbeling BN, Vaughn TE, McCoy KD, Beekmann SE, Woolson RF, Ferguson KJ, et al. Percutaneous injury, blood exposure, and adherence to standard precautions: are hospital‐based health care providers still at risk?. Clinical Infectious Diseases 2003;37(8):1006‐13. - PubMed
Edlich 2003
    1. Edlich RF, Wind TC, Hill LG, Thacker JG, McGregor. Reducing accidental injuries during surgery. Journal of Long‐Term Effects of Medical Implants 2003;13(1):1‐10. - PubMed
Ellenbecker 1996
    1. Ellenbecker MJ. Engineering controls as an intervention to reduce worker exposure. American Journal of Industrial Medicine 1996;29(4):303‐7. - PubMed
Fisman 2002
    1. Fisman DN, Mittleman AM, Sorock GS, Harris AD. Willingness to pay to avoid sharps‐related injuries: a study in injured health care workers. American Journal of Infection Control 2002;30(5):283‐7. - PubMed
Fisman 2007
    1. Fisman DN, Harris AD, Rubin M, Sorock GS, Mittleman AM. Fatigue increases the risk of injury from sharp devices in medical trainees: results from a case‐crossover study. Infection Control and Hospital Epidemiology 2007;28(1):10‐7. - PubMed
Furlan 2009
    1. Furlan AD, Pennick V, Bombardier C, Tulder M. Cochrane Back Review Group, 2009 updated method guidelines for systematic reviews in the Cochrane Back Review Group. Spine (Phil PA 1976) 2009;34:1929‐41. - PubMed
Higgins 2011
    1. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions 5.1.0.[updated March 2011]. The Cochrane Library, Available from: www.cochrane‐handbook.org.
Ilhan 2006
    1. Ilhan MN, Durukan E, Aras E, Turkcuoglu S, Aygun R. Long working hours increase the risk of sharp and needlestick injury in nurses: the need for new policy implication. Journal of Advanced Nursing 2006;56(5):563‐8. - PubMed
Jagger 2008
    1. Jagger J, Perry J, Gomaa A, Kornblatt Phillips E. The impact of US policies to protect healthcare workers from bloodborne pathogens: the critical role of safety‐engineered devices. Journal of Infection and Public Health 2008;1:62‐71. - PubMed
Jagger 2011
    1. Jagger J, Berguer R, Philips EK, Parker G, Gomaa AE. Increase in sharps injuries in surgical settings versus non‐surgical settings after passage of national needlestick legislation. Association of periOperative Registered Nurses Journal 2011;93(3):322‐30. - PubMed
Lavoie 2012
    1. Lavoie MC, Verbeek JH, Parantainen A, Pahwa M. Devices for preventing percutaneous exposure injuries caused by needles in health care personnel. Cochrane Database of Systematic Reviews 2012, Issue 4. [DOI: 10.1002/14651858.CD009740] - DOI - PMC - PubMed
Lefebvre 2008
    1. Lefebvre DR, Strande LF, Hewitt CW. An enzyme‐mediated assay to quantify inoculation volume delivered by suture needlestick injury: two gloves are better than one. Journal of the American College of Surgeons 2008;206(1):113‐22. - PubMed
Mast 2004
    1. Mast E, Mahoney F, Kane M, Margolis H. Hepatitis B vaccines. In: Plotkin OW editor(s). Vaccines. Philadelphia: Saunders, 2004:299‐337.
Meyers 2008
    1. Meyers DJ, Epling C, Dement J, Hunt D. Risk of sharp device‐related blood and body fluid exposure in operating rooms. Infection control and hospital epidemiology 2008;29:1139‐48. - PubMed
Miller 1994
    1. Miller SS, Sabharwal A. Subcuticular skin closure using a blunt needle. Annals of the Royal College of Surgeons England 1994;76:281. - PMC - PubMed
NIOSH 2008
    1. NIOSH. Use of blunt‐tip suture needles to decrease percutaneous injuries to surgical personnel. Safety and Health Information Bulletin 2008, issue 101:1‐4.
Oh 2005
    1. Oh HS, Yi SE, Choe KW. Epidemiological characteristics of occupational blood exposures of healthcare workers in a university hospital in South Korea for 10 years. Journal of Hospital Infection 2005;60(3):269‐75. - PubMed
Orji 2002
    1. Orji EO, Fasubaa OB, Onwudiegwu U, Dare FO, Ogunniyi SO. Occupational health hazards among health care workers in an obstetrics and gynaecology unit of a Nigerian teaching hospital. Journal of Obstetrics and Gynaecology 2002;22(1):75‐8. - PubMed
Parantainen 2012
    1. Parantainen A, Verbeek JH, Lavoie MC, Pahwa M. Extra gloves or special types of gloves versus a single pair of gloves for preventing percutaneous exposure injuries in healthcare personnel. Cochrane Database of Systematic Reviews 2012, Issue 1. [DOI: 10.1002/14651858.CD009573] - DOI - PMC - PubMed
Pruss‐Ustun 2005
    1. Pruss‐Ustun A, Rapiti E, Hutin Y. Estimation of the global burden of disease attributable to contaminated sharps injuries among health‐care workers. American Journal of Industrial Medicine 2005;48(6):482‐90. - PubMed
RevMan 2011 [Computer program]
    1. RevMan. Review Manager (RevMan). Version 5.1 for Windows. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
Roberts 1999
    1. Roberts RB, Lincoff AS, Frankel RE. Occupational exposure to HIV in an urban university hospital setting. Brazilian Journal of Infectious Diseases 1999;3(2):50‐62. - PubMed
Robinson 2002
    1. Robinson KA, Dickersin K. Development of a highly sensitive search strategy for the retrieval of reports of controlled trials using PubMed. International Journal of Epidemiology 2002;31(1):150‐3. - PubMed
Roelofs 2003
    1. Roelofs CR, Barbeau EM, Ellenbecker MJ, Moure‐Eraso R. Prevention strategies in industrial hygiene: a critical literature review. American Industrial Hygiene Association Journal 2003;64(1):62‐7. - PubMed
Smith 1988
    1. Smith JR, Grant JM. Does wearing two pairs of gloves protect against skin contamination?. BMJ 1988;297:1193. - PMC - PubMed
Smith 1990
    1. Smith JR, Grant JM. The incidence of glove puncture during caesarean section. Journal of Obstetrics and Gynaecology 1990;10:317‐8.
Smith 2006
    1. Smith DR, Choe MA, Jeong JS, Jeon MY, Chae YR, An GJ. Epidemiology of needlestick and sharps injuries among professional Korean nurses. Journal of Professional Nursing 2006;22(6):359‐66. - PubMed
Smith 2006b
    1. Smith DR, Mihashi M, Adachi Y, Nakashima Y, Ishitake T. Epidemiology of needlestick and sharps injuries among nurses in a Japanese teaching hospital. Journal of Hospital Infection 2006;64(1):44‐9. - PubMed
Sohn 2006
    1. Sohn JW, Kim BG, Kim SH, Han C. Mental health of healthcare workers who experience needlestick and sharps injuries. Journal of Occupational Health 2006;48(6):474‐9. - PubMed
Stafford 1998
    1. Stafford MK, Pitman MC, Nanthakumaran N, Smith JR. Blunt‐tipped versus sharp‐tipped needles: wound morbidity. Journal of Obstetrics and Gynaecology 1998;Jan 18(1):18‐9. [PUBMED: 15511994] - PubMed
Tarantola 2006
    1. Tarantola A, Golliot F, L'Heriteau F, Lebascle K, Ha C, Farret D, Bignon S, Smail A, Doutrellott‐Philippon C, Astagneau P, Bouvet E. Assessment of preventive measures for accidental blood exposure in operating theaters: a survey of 20 hospitals in Northern France. American Journal of Infection Control 2006;34:376‐382. - PubMed
Verbeek 2005
    1. Verbeek J, Salmi J, Pasternack I, Jauhiainen M, Laamanen I, Schaafsma F, et al. A search strategy for occupational health intervention studies. Journal of Occupational and Environmental Medicine 2005;62(10):682‐7. - PMC - PubMed
Wallis 2007
    1. Wallis GC, Kim WY, Chaudhary BR, Henderson JJ. Perceptions of orthopaedic surgeons regarding hepatitis C viral transmission: a questionnaire survey. Annals of the Royal College of Surgeons of England 2007;89(3):276‐80. - PMC - PubMed
Watt 2008
    1. Watt AM, Patkin M, Sinnott MJ, Black RJ, Maddern GJ. Scalpel injuries in the operating theatre. BMJ 2008;336:1031. - PMC - PubMed
Watt 2010
    1. Watt AM, Patkin M, Sinnott MJ, Black RJ, Maddern GJ. Scalpel safety in the operative setting: a systematic review. Surgery 2010;147(1):98‐106. - PubMed
WHO 2007
    1. World Health Organization. Needlestick injuries: implementation of pilot projects to reduce sharps injuries in health care workers. http://www.who.int/occupational_health/topics/needinjuries/en/index.html (Accessed 5 September 2007).

References to other published versions of this review

Parantainen 2008
    1. Parantainen A, Lavoie MC, Pahwa M, Verbeek JH. Prevention of percutaneous injuries with risk of hepatitis B, hepatitis C, or other viral infections for health care workers. Cochrane Database of Systematic Reviews 2008, Issue 2. [DOI: 10.1002/14651858.CD007197] - DOI
Parantainen 2011
    1. Parantainen A, Verbeek JH, Lavoie MC, Pahwa M. Blunt versus sharp suture needles for preventing percutaneous exposure incidents in surgical staff. Cochrane Database of Systematic Reviews 2011, Issue 6. [DOI: 10.1002/14651858.CD009170] - DOI - PMC - PubMed

Publication types