Effectiveness of measures to prevent needlestick injuries among ...

4 Intervention program evaluation
all used gloves were tested for perforation, a surrogate measure of risk of NSI. In
addition to reducing likelihood of confounding by random allocation to the blunt
versus traditional needle groups, the authors evaluated potential confounding by
time of day, operation length, and surgeon experience.
Overall, 14 NSI were observed, all due to sharp needles. Seventy-six perforations
were detected in 69 pairs of gloves, and 58 of them (76 %) were from sharp needles.
Glove perforations during abdominal fascia closure were found to be mostly related
to use of sharp needles (50 % due to sharp needles versus 7 % due to blunt needles;
p < 0.0006). Surgeon experience and duration of procedure were not associated with
the likelihood of NSI or glove perforation, but skin contamination was more likely to
occur during procedures carried out during the night shift.
� Intermediate quality
The remaining five evaluations of blunt suture needles were rated “intermediate”
quality [61 to 65]. Three of these articles described evaluations of the Ethigard
(Ethicon) blunt suture needle: Hartley et al. reported a decrease in the rate of glove
perforation from 14/39 sharp needles used to 3/46 when the Ethigard was used,
p < 0.001 [62]. Wright et al. noted 31 perforations in 16 out of 62 gloves worn while
using a “cutting needle” and 18 perforations in ten out of 76 gloves worn while using
a “taperpoint needle” (p = 0.049). In addition, three NSI were reported, two from
cutting needles and one from a wound-drain introducer, but none from the Ethigard
[64]. The final study in this group reported a reduction from 5.9 NSI/100 procedures
prior to introduction of the Ethigard to 1.1 NSI/100 procedures after the Ethigard was
adopted [61]. Rice et al. evaluated the Maxon Protec blunt suture needle (Davis and
Geck, Inc.), and found that 16 % of outer and 6 % of inner gloves were perforated
when traditional sharp needles were used, but there were no perforations among
gloves worn by surgeons using the Maxon Protec (p = 0.026) [63]. Meyer et al. found
that 39 % of surgical gloves were perforated when standard sharp needles were used,
compared to 23 % of gloves perforated with use of the Protect Point (Maxon-Faden)
blunt suture needle [65].
Report „Needlestick injuries“ 43