World J Surg (2017) 41:2413 DOI 10.1007/s00268-017-3941-7 LETTE R T O T HE EDI T OR Needlestick Injuries, Glove Perforation and Round-Tipped Blunt Needles 1 1 2 1 • • • • Andrea Mingoli Gioia Brachini Giovanna Sgarzini Barbara Binda Martina Zambon Published online: 3 March 2017 Socie ´te ´ Internationale de Chirurgie 2017 Dear Sir, effort is required to pass the needle through muscles and We read with great interest the article by Battersby et al. fascia, the needle tip is often hidden from the direct vision  about the impairment of surgical knot quality due to of the surgeon, and the surgeon may have decreased double gloving. The practice to wearing two pairs of gloves attention, being often at the end of an exhausting emer- during surgical procedures to reduce the risks of exposure gency procedure. to patient’s blood and transmission of infectious organisms In our experience, sharp needles were responsible for all has been recommended worldwide, by several healthcare needlestick injuries and the risk of glove perforation was authorities, also on the basis of a Cochrane review showing sevenfold lower when blunt needles were used. From that the absence of compromised dexterity as a result of double time, we routinely use the blunt needle for celiotomy clo- gloving . The study performed by Battersby and Col- sure with excellent results. leagues clearly shows that double gloving reduces the In conclusions, we believe that blunt needles represent quality of surgical knots by 24%, no matter the suture type one of the more effective modalities to prevent hand used. A wider reduction of knot quality (50%) was noted needlestick injuries and contamination and that they should with 4.0 sutures. These results question the safety of sur- always be used, especially in emergency surgical gical knots tied wearing double gloves and, as a conse- procedures. quence, push surgeons to consider other precautions to reduce bloody contamination during surgery. The use of blunt needles seems to be a valid modality to References reduce the risk of intraoperative glove perforation, percu- taneous injuries and contact between exposed skin and 1. Battersby CLF, Battersby NJ, Hollyman M, Hunt JA (2016) patient’s blood. We performed a randomized study Double-gloving impairs the quality of surgical knot tying: a designed to determine whether the use of a round-tipped randomized controlled trial. World J Surg 40:2598–2602. doi:10. blunt needle for abdominal fascia closure after an emer- 1007/s00268-016-3577-z 2. Mischke C, Verbeek JH, Saarto A et al (2014) Gloves, extra gloves gency operation could be effective in reducing the fre- or special types of gloves for preventing percutaneous exposure quency of injuries and glove perforation and increasing injuries in healthcare personnel. Cochrane Database Syst Rev. surgeons’ safety . During the abdominal fascia suture, doi:10.1002/14651858.CD009573.pub2 there is, in fact, the greatest risk for contamination, with a 3. Mingoli A, Sapienza P, Sgarzini G et al (1996) Inﬂuence of blunt needles on surgical glove perforation and safety for the surgeon. needlestick injury rate of 52–76% [4, 5], because a great Am J Surg 172:512–517 4. Dauleh MI, Irving AD, Townell NH (1994) Needle prick injury to the surgeon: do we need sharp needles? J R Coll Surg Edinb & Andrea Mingoli 39:310–311 firstname.lastname@example.org 5. Hussain SA, Latif AB, Choudhary AA (1988) Risk to surgeons: a survey of accidental injuries during operations. Br J Surg Emergency Department and Department of Surgery P. 75:314–316 Valdoni, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy Azienda Osp. S. Giovanni Addolorata, Rome, Italy
World Journal of Surgery – Springer Journals
Published: Mar 3, 2017
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