Time to consider blunt needles for implant surgery? A systematic review and meta-analysis shows that blunt suture needles reduce glove perforation.

Autor: O'Donnell O; Department of General Surgery, Portiuncula University Hospital, Saolta University Health Care Group, Dunlo, Ballinasloe, H53 T971, Co. Galway; Royal College of Surgeons in Ireland, School of Postgraduate Studies, 123 St Stephen's Green, Dublin 2, D02 YN77, Ireland. Electronic address: oisinodonnell20@rcsi.com., Gallagher C; University of Limerick School of Medicine, University of Limerick, Sreelane, Castletroy, Co. Limerick, V94 T9PX, Ireland. Electronic address: clodaghgallagher91@gmail.com., Chaudhary AM; Department of General Surgery, Portiuncula University Hospital, Saolta University Health Care Group, Dunlo, Ballinasloe, H53 T971, Co. Galway; Discipline of Surgery, School of Medicine, Clinical Science Institute, National University of Ireland Galway, University Rd, Galway, H91TK33, Ireland. Electronic address: AliMuhmmad.Chaudhary@hse.ie., Iqbal A; Department of General Surgery, Portiuncula University Hospital, Saolta University Health Care Group, Dunlo, Ballinasloe, H53 T971, Co. Galway; Discipline of Surgery, School of Medicine, Clinical Science Institute, National University of Ireland Galway, University Rd, Galway, H91TK33, Ireland. Electronic address: asifiqbal206@icloud.com.
Jazyk: angličtina
Zdroj: The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland [Surgeon] 2024 Apr; Vol. 22 (2), pp. 107-115. Date of Electronic Publication: 2023 Nov 10.
DOI: 10.1016/j.surge.2023.10.009
Abstrakt: Background: Despite a recent Cochrane Review demonstrating blunt suture needles are safer for surgeons, the use of blunt suture needles has not become widely adopted. In the 'Implant Era', with the value of medical implant companies to surpass $145 billion by 2027, should we re-examine the use of blunt suture needles, especially to reduce infection in implant surgery? We performed a systematic review and meta-analysis of randomised controlled trials (RCTs) assessing whether blunt suture needles reduce risks to surgeons and patients.
Methods: A systematic review and meta-analysis was performed per PRISMA guidelines. PubMed, Cochrane and EMBASE databases were searched for RCTs. Dichotomous variables were pooled as risk ratios (RR) and associated 95% confidence intervals (CI) using the MH method. Random or fixed effects modelling use was based on statistical heterogeneity (I 2 ).
Results: 14 RCTs were identified with 2488 patients. The RCTs included laparotomies, caesarean sections, episiotomies, and orthopaedic surgeries. Blunt suture needles when compared with sharp needles resulted in a significant reduction in glove perforation; RR: 0.47, 95% CI [0.37 to 0.60] and needlestick injuries, RR: 0.50, 95% CI [0.26 to 0.97]. Sharp needles caused more wound infections, but the result was not statistically significant; RR: 2.73, 95% CI [0.54 to 13.76], p 0.22. Surgeon's satisfaction decreased with blunt needles compared with sharp (RR: 1.22, 95% CI [1.09 to 1.37]).
Conclusion: Blunt suture needles are safer than sharp needles for surgeons and likely reduce risks to patients. This, however, comes at the cost of decreased ease of use. The authors recommend the routine use of blunt suture needles, especially in implant surgery.
Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare.
(Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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