controlled trial reporting no difference in needlestick rates
with HFT use.
Therefore the ACS recommends:
• The use of HFT as an adjunctive safety measure to reduce
sharps injuries during a surgical procedure except in situations where it may compromise the safe conduct of the
operation, in which case a partial HFT may be used.
Engineered sharps injury prevention devices
Engineered sharps injury prevention (ESIP) mechanical
devices may provide varying degrees of mechanical protection from sharps injuries involving suture needles and
scalpel blades. Manufacturers of ESIP devices approved by
the U.S. Food and Drug Administration have been permit-ted to claim prevention of sharps injury as a feature of their
use. No study published to date demonstrates the clinical
effectiveness of ESIP devices. The design and quality of
these devices has been variable and their acceptance among
surgeons limited. Nevertheless, these devices may contribute to minimizing sharps injuries in the OR.
Therefore the ACS recommends:
• The use of ESIP devices as an adjunctive safety measure to
reduce sharps injuries during surgery except in situations
where it may compromise the safe conduct of the operation
or safety of the patient. ♦
The ACS offers this statement for consideration by surgeons,
their hospitals, and health care organizations. This statement is
provided as general guidance. It does not constitute a standard
of care and is not intended to replace the professional judgment
of the surgeon or health care administrator. This statement may
be reviewed and modified as necessary to conform with the laws
of the applicable jurisdiction, the circumstances of the individual
hospital and health care organization, and requirements of other
allied and health care organizations.
Aarnio P, Laine T. Glove perforation rate in vascular
surgery—A comparison between single and double
gloving. Vasa. 2001; 30( 2):122-124.
Berguer R, Heller PJ. Strategies for preventing sharps
injuries in the operating room. Surg Clin North Am.
2005; 85( 6):1288-305.
Eggleston MK Jr, Wax JR., Philput C, et al. Use of
surgical pass trays to reduce intraoperative glove
perforations. J Matern Fetal Med. 1997; 6( 4):245-247.
Jagger J, Bentley M, Tereskerz P. A study of patterns
and prevention of blood exposures in OR personnel.
AORN J. 1998; 67( 5):979-981, 983-974, 986-977.
Jagger J, Berguer R, Phillips EK, Parker G, Gomaa AE.
Increase in sharps injuries in surgical settings
versus nonsurgical settings after passage of
national needlestick legislation. J Am Coll Surg.
Jensen SL. Double gloving—Electrical resistance and
surgeons’ resistance. Lancet. 2000;355(9203):514-515.
Laine T, Aarnio P. How often does glove perforation
occur in surgery? Comparison between single
gloves and a double-gloving system. Am J Surg.
Naver LP, Gottrup F. Incidence of glove perforations in
gastrointestinal surgery and the protective effect of
double gloves: A prospective, randomised controlled
study. Eur J Surg. 2000;166( 4):293-295.
O’Malley EM, Scott RDII, Gayle J, et al. Costs of
management of occupational exposures to blood
and body fluids. Infect Control Hosp Epidemiol.
2007; 28( 7):774-782.
Parantainen A, Verbeek JH, Lavoie MC, Pahwa M.
Blunt versus sharp suture needles for preventing
percutaneous exposure incidents in surgical staff.
Cochrane Database of Systemic Reviews. 2011; Issue 11,
Art. No.: CD009170. DOI: 10. 1002/14651858.
Stringer B, Infante-Rivard C, Hanley JA. Effectiveness
of the hands-free technique in reducing
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The use of blunt-tip suture needles does not require the surgeon to
change their work practices.... The College recognizes that specific
procedures may preclude the use of blunt-tip suture needles.