Evaluation of a new needle catching instrument for suturing simple wounds in the Emergency Department

Abstract

The Needlecatcher comprises a tissue forceps at one end, with a 'piston and barrel' system, which acts as a needle grasper, at the other end of the instrument. It minimizes exposure of the needle during suturing, potentially reducing risk of injury. We evaluate its effect on operator safety during simple wound closure. Video analysis of 10 clinicians (six junior doctors and four advanced nurse practitioners) closing a standard simulated wound using their normal technique was performed. They were trained in the use of the Needlecatcher, and used it for 10 weeks closing simple wounds in the Emergency Department. Video analysis of wound closure was repeated, using the new instrument. Clinicians filled out a questionnaire for each episode of wound closure, which assessed how they perceived their safety was affected by the device. Video analysis of clinicians showed that the needle was secured in an instrument and thus unexposed for an average of 60% of the duration of the procedure by standard technique, compared with 95% using the Needlecatcher, with a change of 35% [95% confidence interval (CI): 14-58%, P = 0.005]. Episodes where the needle was grasped by an operator's finger were reduced by 50% (95% CI: 15-85%, P = 0.028). In the questionnaire study of 53 episodes of wound closure, operators perceived their safety to be increased in 38 (71.7%, 95% CI: 66.2-77.2%) episodes, were neutral in 10, and felt their safety was reduced in five. The Needlecatcher showed the potential to reduce the risk of needlestick injury while suturing.