Glove Perforation Research Articles

Evaluation of Surgical Glove Perforation after Laparoscopic and Open Cholecystectomy

Background : Surgical gloves provide a protective barrier against blood-born pathogens. Studies reveal glove perforation rates of up to 45%, which are often unrecognized by the surgeon or nurse. The goal of this study was to evaluate how often glove perforation occurs after laparoscopic and open cholecystectomy.Methods : Gloves from the operating surgeon and the first assistant were collected after operation and tested immediately using two methods :1. Water leak test - the approved standardized method to detect holes after filling up the gloves with 1000ml of water.2. Electrical resistance test - method to detect gloves conductivity immersed in saline bath.Results : Altogether, 376 gloves were studied. The overall perforation rate was 8%. Perforations more frequently were observed after laparoscopic than open cholecystectomy. The gloves worn by the operator were more likely to be perforated than those worn by the assistant surgeon in both types of operations. The most common site of perforation was in the index finger of the non-dominant hand. Thirty percent of gloves conducted electrical current, while 22% of them had no macroscopic evidence of perforation.Conclusion : Many of gloves might have microperforations that can not be detected using water leak test.

Glove Punctures in Orthopedics and Trauma Surgery: Frequency and Nature of Occurrence

Background : Glove punctures are a common occurrence in surgical practice and especially in orthopedic practice. Intact gloves protect members of the operating team from transmission of blood borne infections. Glove punctures however expose the members of the operating team to body fluids and increase the risk of these infections. With the prevalence of conditions such as HIV, Hepatitis B and C, this study aims at determining the rate of and factors that determine glove perforations. Methodology: Gloves were collected from consecutive orthopedic procedures, and were tested using the standardized water leak test The gloves were assessed for leaks and a control group of unused gloves from the same pack was tested similarly after each procedure. Results: A glove perforation rate of 7.7% (119/1548) was found with operative perforation rate of 48.2%. The surgeons' glove was the most frequently perforated 19.3% (85/440). The Index finger and thumb were the most commonly perforated digits 70.8% and 15.6% of perforations respectively. The outer glove had a higher rate compared to inner glove 80.7% to 19.3% respectively. Surgeries lasting more than 90minutes were associated with more perforations (70.4%). Conclusion : The use of double gloving techniques is advocated and a change of outer gloves for prolonged procedures is encouraged as this will reduce the risk of exposure. Key Words: Glove, Punctures, Orthopedics, surgery.

Evaluation of an antimicrobial surgical glove to inactivate live human immunodeficiency virus following simulated glove puncture

Percutaneous injuries associated with cutting instruments, needles, and other sharps (eg, metallic meshes, bone fragments, etc) occur commonly during surgical procedures, exposing members of surgical teams to the risk for contamination by blood-borne pathogens. This study evaluated the efficacy of an innovative integrated antimicrobial glove to reduce transmission of the human immunodeficiency virus (HIV) following a simulated surgical-glove puncture injury. A pneumatically activated puncturing apparatus was used in a surgical-glove perforation model to evaluate the passage of live HIV-1 virus transferred via a contaminated blood-laden needle, using a reference (standard double-layer glove) and an antimicrobial benzalkonium chloride (BKC) surgical glove. The study used 2 experimental designs. In method A, 10 replicates were used in 2 cycles to compare the mean viral load following passage through standard and antimicrobial gloves. In method B, 10 replicates were pooled into 3 aliquots and were used to assess viral passage though standard and antimicrobial test gloves. In both methods, viral viability was assessed by observing the cytopathic effects in human lymphocytic C8166 T-cell tissue culture. Concurrent viral and cell culture viability controls were run in parallel with the experiment's studies. All controls involving tissue culture and viral viability were performed according to study design. Mean HIV viral loads (log(10)TCID(50)) were significantly reduced (P < .01) following passage through the BKC surgical glove compared to passage through the nonantimicrobial glove. The reduction (log reduction and percent viral reduction) of the HIV virus ranged from 1.96 to 2.4 and from 98.9% to 99.6%, respectively, following simulated surgical-glove perforation. Sharps injuries in the operating room pose a significant occupational risk for surgical practitioners. The findings of this study suggest that an innovative antimicrobial glove was effective at significantly (P < .01) reducing the risk for blood-borne virus transfer in a model of simulated glove perforation.

Prevention and control of surgical site infections: review of the Basel Cohort Study

Surgical site infections (SSI) are the most common hospital-acquired infections among surgical patients, with significant impact on patient morbidity and health care costs. The Basel SSI Cohort Study was performed to evaluate risk factors and validate current preventive measures for SSI. The objective of the present article was to review the main results of this study and its implications for clinical practice and future research. The prospective observational cohort study included 6,283 consecutive general surgery procedures closely monitored for evidence of SSI up to 1 year after surgery. The dataset was analysed for the influence of various potential SSI risk factors, including timing of surgical antimicrobial prophylaxis (SAP), glove perforation, anaemia, transfusion and tutorial assistance, using multiple logistic regression analyses. In addition, post hoc analyses were performed to assess the economic burden of SSI, the efficiency of the clinical SSI surveillance system, and the spectrum of SSI-causing pathogens. The overall SSI rate was 4.7% (293/6,283). While SAP was administered in most patients between 44 and 0 minutes before surgical incision, the lowest risk of SSI was recorded when the antibiotics were administered between 74 and 30 minutes before surgery. Glove perforation in the absence of SAP increased the risk of SSI (OR 2.0; CI 1.4-2.8; p <0.001). No significant association was found for anaemia, transfusion and tutorial assistance with the risk of SSI. The mean additional hospital cost in the event of SSI was CHF 19,638 (95% CI, 8,492-30,784). The surgical staff documented only 49% of in-hospital SSI; the infection control team registered the remaining 51%. Staphylococcus aureus was the most common SSI-causing pathogen (29% of all SSI with documented microbiology). No case of an antimicrobial-resistant pathogen was identified in this series. The Basel SSI Cohort Study suggested that SAP should be administered between 74 and 30 minutes before surgery. Due to the observational nature of these data, corroboration is planned in a randomized controlled trial, which is supported by the Swiss National Science Foundation. Routine change of gloves or double gloving is recommended in the absence of SAP. Anaemia, transfusion and tutorial assistance do not increase the risk of SSI. The substantial economic burden of in-hospital SSI has been confirmed. SSI surveillance by the surgical staff detected only half of all in-hospital SSI, which prompted the introduction of an electronic SSI surveillance system at the University Hospital of Basel and the Cantonal Hospital of Aarau. Due to the absence of multiresistant SSI-causing pathogens, the continuous use of single-shot single-drug SAP with cefuroxime (plus metronidazole in colorectal surgery) has been validated.

Comparative Assessment Between Eyelet Wiring and Direct Interdental Wiring for Achieving Intermaxillary Fixation: A Prospective Randomized Clinical Study

The intention of this study was to compare the efficacy of eyelet wiring and direct interdental (Gilmer) wiring for achieving intermaxillary fixation (IMF). This study was a prospective randomized clinical trial. The study sample was derived from the population of patients who underwent IMF at the Department of Oral and Maxillofacial Surgery, Sharad Pawar Dental College, Wardha, India, between October 2008 and September 2010. The time required for placement and removal (in minutes) was compared between the eyelet wiring and direct interdental wiring techniques. Postoperative stability after achieving IMF was analyzed in the 2 groups. The plaque accumulation in both groups was evaluated using the Turesky-Gilmore-Glickman modification of the Quigley-Hein plaque index. Complications in the form of soft tissue injury, glove puncture, and trauma to the operator's finger were also recorded. Statistical analysis was performed with SPSS statistical software for Windows, version 8.0 (SPSS, Chicago, IL) using the χ(2) test and Student t test. The mean working time for placement and removal of eyelet wiring (group I) was 18.00 minutes and 9.67 minutes, respectively. For direct interdental wiring (group II), it was 30.50 minutes and 23.12 minutes, respectively. The mean plaque index values were 1.78 and 2.54 for groups I and II, respectively, which signifies a higher plaque deposition in group II. No occlusal disturbance was seen in either group. The incidences of glove perforation, soft tissue trauma, and trauma to the operator's finger were higher in group II. Eyelet wiring is preferable to direct interdental wiring as evidenced by fewer complications, and requires a shorter operating time in patients with minimally displaced fractures.

Surgical glove bacterial contamination and perforation during total hip arthroplasty implantation: When gloves should be changed

Double gloving is recommended in orthopedic surgery, notably in total hip arthroplasties (THA) to prevent contamination of the surgical site. Systematic glove changes during the key phases of hip prosthesis implantation reduce the frequency of occult perforations and bacterial loading of glove surfaces. During 29 THA implantation procedures, we evaluated the bacterial contamination of the outer glove surface and its perforation rate. Contaminations were sought by placing the gloved fingertips on blood geloses (incubation, 48 h at 37°C), and perforations were sought using a water test (NF EN 455-1). One intervention was excluded from the study because an initial contamination was detected, leaving 28 cases analyzed. Fifteen interventions (53.6%) presented contaminated geloses (26 contaminated glove changes for 3.38% of the gloves used). These contaminations were found on the gloves of all of the gloved personnel, with no distinction as to the right or left side. Thirty-eight percent of the contaminations occurred during joint reduction, whereas the other surgical stages grouped 15-26% of the contaminations (P<0.05). Twenty-nine bacteria were identified: 62% coagulase-negative staphylococci (16% of which were methicillin-resistant). Twenty-eight perforations were identified (3.5% of the gloves used), 67.8% of which were located on the operator and 64.3% on the dominant side. Eighty percent of the perforations occurred during the "surgical incision" and the "cup and stem implantation" stages (respectively, 5.0% and 5.5% of the gloves used during the surgical time) (P<0.05), without being associated with an increased risk of bacterial contamination. At the 12-month clinical follow-up, no infectious complications were found. On the gloves worn by the 20 surgical team members contaminated during these 28 surgical procedures, replacing contaminated gloves with new sterile gloves rendered all the bacteriological samples of the subsequent surgical stages negative in 16 cases (80%). Increasing the number of outer glove renewals, notably during certain surgical stages at risk for contamination (prosthesis reduction) or perforation (surgical incision/femoral cementing) can reduce the risk of contamination and perforation. The bacteria isolated suggest a cutaneous origin. Regularly changing gloves has resulted in a sterile state in 80% of cases. LEVEL OF EVIDENCE AND TYPE OF STUDY: Level III prospective diagnostic study.

Risk of surgical glove perforation in oral and maxillofacial surgery

Oral and maxillofacial surgery, which involves several sharp instruments and fixation materials, is consistently at a high risk for cross-contamination due to perforated gloves, but it is unclear how often such perforations occur. This study aimed to address this issue. The frequency of the perforation of surgical gloves (n=1436) in 150 oral and maxillofacial surgeries including orthognathic surgery (n=45) was assessed by the hydroinsufflation technique. Orthognathic surgery had the highest perforation rate in at least 1 glove in 1 operation (91.1%), followed by cleft lip and palate surgery (55.0%), excision of oral soft tumour (54.5%) and dental implantation (50.0%). The perforation rate in scrub nurses was 63.4%, followed by 44.4% in surgeons and first assistants, and 16.3% in second assistants. The odds ratio for the perforation rate in orthognathic surgery versus other surgeries was 16.0 (95% confidence interval: 5.3–48.0). The protection rate offered by double gloving in orthognathic surgery was 95.2%. These results suggest that, regardless of the surgical duration and blood loss in all fields of surgery, orthognathic surgery must be categorized in the highest risk group for glove perforation, following gynaecological and open lung surgery, due to the involvement of sharp objects.

A Prospective Analysis of Glove Perforation in Primary and Revision Total Hip and Total Knee Arthroplasty

Literature in regard to glove perforation rates in revision total joint arthroplasty (TJA) is scarce. Our purpose was to determine the incidence of perforation in revision TJA. Gloves from all scrubbed personnel were tested based on the American Society for Testing and Materials. A total of 3863 gloves were collected from 58 primary and 36 revision arthroplasty cases. Surgeons had a 3.7% outer-glove perforation rate in primary TJA compared with 8.9% in revision TJA. When both gloves were perforated, the outer-glove perforation was recognized intraoperatively 100% of the time, and the inner-glove perforation was noted only 19% of the time. The surgeon has the highest rate of glove perforation. Outer-glove perforations should prompt careful inspection of the inner glove.

Role of blunt suture needle in episiotomy repair at uncomplicated vaginal deliveries in reducing glove perforation rate: A randomized controlled trial

The aim of this study was to evaluate the role of blunt suture needles for episiotomy repair at uncomplicated vaginal deliveries in reducing glove perforation rate. This was a prospective randomized controlled trial wherein 300 nulliparous women with uncomplicated vaginal deliveries were randomized to episiotomy repair with either blunt or sharp suture needles. Patient demographics and clinical variables were collected. Postoperatively, the surgeons were surveyed regarding ease of using the needle, and glove perforation was determined by three tests: air insufflation, water filling and water load. A total of 41 perforations occurred in the 39 episiotomy repairs with glove perforations (13%). There was a significantly higher number of glove perforations using the sharp suture needles (28/150; 18.7%) than with the blunt suture needles (11/150; 7.3%) (P = 0.005). Glove perforation of the non-dominant hand occurred in 90% of the cases. Using a blunt suture needle took significantly more time (P < 0.001) to complete the repair than using a sharp needle. Surgeons reported that blunt needles were more difficult to use than sharp needles (P < 0.001). Blunt suture needles for episiotomy repair were shown to have a significantly lower instance of glove perforation but required more time and are perceived to be more difficult to complete the repair as compared to sharp needles.

Exploring the Benefits of Double Gloving During Surgery

Breaches in the glove barrier pose a risk for transmission of bloodborne pathogens during surgical procedures. Double gloving or double gloving with an indicator glove system may provide added protection. For this 24-month study, we used a comparative design to examine the effect of double gloving with inner indicator gloves on the durability of inner gloves and the detection of glove tears or perforations during surgery. The frequency of seeing blood on the hand after surgery was greater with single gloving than with double gloving, and the frequency of changing gloves during surgery was significantly higher among those who double gloved with an indicator glove system versus double gloving alone. The majority of health care providers in our study expressed favorable views about double gloving.

Is double-gloving really protective? A comparison between the glove perforation rate among perioperative nurses with single and double gloves during surgery

BackgroundSurgical teams rely on surgical gloves as a barrier to protect themselves against blood-borne pathogenic infections during surgery. Double-gloving is adopted by surgeons to tackle the problem of glove perforation. Nevertheless, double-gloving is not practiced commonly by operating room nurses and there are only limited studies about double-gloving that targets only perioperative nurses. The aim of this research was to assess the effectiveness of double-gloving in protecting perioperative nurses by comparing the frequency of glove perforation between single-gloving and double-gloving groups. MethodsA prospective and randomized study was performed. Nurses were assigned randomly to single-gloved and double-gloved groups for comparison of the glove perforation rate. Water-leakage and air-inflation tests were used to detect glove perforation. ResultsGlove perforations was detected in 10 of 112 sets of single-gloves (8.9%) and 12 of 106 sets of outer gloves in the double-gloved group (11.3%). There was no inner double-glove perforation (0%). Glove perforations were found in 6 and 4 of the 112 sets of single-gloves for the first assistants (5.36%) and the scrub nurses (3.57%), and 5 and 7 of 106 sets of outer gloves in the double-gloved group for the first assistants (4.72%) and the scrub nurses (6.60%), respectively. The average occurrence of perforation was 69.8 minutes (range, 20–110 min) after the beginning of surgery. The sites of perforation were localized mostly on the left middle finger (42%) and the left ring finger (33.3%). ConclusionsBased on the findings of the study, double-gloving is indeed effective in protecting operating room nurses against blood-borne pathogen exposure. It should be introduced as a routine practice.

Surgical glove perforation – Raising the bar for safety during cardiac surgery

Surgical glove perforation – Raising the bar for safety during cardiac surgery

Glove perforation time and frequency in total hip arthroplasty procedures

The aim of the present study was to investigate glove perforation rate and time and evaluate the factors affecting glove perforation in total hip arthroplasty (THA). Nine hundred seventy-nine gloves used in 57 THA procedures were assessed according to the perforation. Forty-four (77.2%) procedures were primary THA and 13 (22.8%) were revision THA. Gloves were changed when perforated, become dirty with blood or blood products, and before bone cementing. All gloves were filled with water at the end of the operation and controlled for perforation. Two hundred and one surgical gloves used during scrubbing and removed after draping the patient were examined as the control group. The location (which finger), number and time of the perforation, surgery type and duration, and distribution of the perforation location according to the surgical team were assessed. Patients' mean age was 62.9 ± 14.6 (range: 33 to 97) years and the mean surgery duration was 162.9 ± 32.0 minutes. Thirty-two glove perforations were noted in 19 of the operations. Of these perforations, 28 belonged to the surgeons and first assistants. There was no significant difference between the dominant or non-dominant hand according to the location of perforations. Perforations in the first and second fingers of the gloves accounted for 81.3% of all perforations. There was no significant difference in terms of number of gloves used, perforation numbers and operation duration between the primary and revision THA procedures. Two perforated gloves (0.99%) were found in the control group and the difference between the number of perforations in the control and study groups was significant (p=0.048). We recommend the use of two pairs of gloves to avoid the risk of contamination and protect the surgical team from infectious disease in major surgeries like THA. Surgical gloves should be changed when they are excessively contaminated with surgical fluids and the surgeon and first assistant should also change their outer gloves at an average of every 90 minutes.

Glove perforation in cardiac surgery-when does it occur and does it matter?

Glove perforation in cardiac surgery-when does it occur and does it matter?

The use of homografts in the operative management of infective endocarditis has lower short and medium-term mortality and improved overall outcome compared to prosthetic valves

s / International Journal of Surgery 10 (2012) S1–S52 S16 ABSTRACTS wiring. We found no correlation between glove perforation and sternal wound infection. 0153: DOES EXPLORATIVE THORACOTOMY FOR NON-SMALL CELL LUNG CANCER (NSCLC) ADVERSELY AFFECT PATIENTS’ OUTCOME POSTOPERATIVELY? James Rigby, Aiman Alzetani, Adam Lea, Shilajit Ghosh. University Hospital of North Staffordshire, Stoke-on-Trent, UK Aims: To determine our incidence of explorative thoracotomy for NSCLC and its influence on further management of patients & their survival. Methods: Retrospective review of patients referred for lung cancer surgery over 2.5 years. Clinical data were collected on radiological/pathological staging and post-operative management including survival status. Results: Between January 2008-August 2011, 418 patients underwent thoracotomy for primary lung cancer, of which 27 patients (6%) had inoperable disease. Of the inoperable cases, 4 (15%) had a pre-explorative mediastinoscopy and 22 (81%) were investigated with PET studies. Sixteen patients (59%) had radiological-advanced stage (IIIA-). Inoperability was due to stage migration, N2 disease, tumour invasion or poor physiological status intra-operatively. Subsequent treatments included adjuvant (chemotherapy/ radiotherapy /combined) in 16 patients (59%) of which 12 (75%) are still alive with an average length of survival of 9 months. Conclusion: Our incidence of explorative thoracotomy is well within those reported in the literature. Over half of patients were still suitable for radical adjuvant treatment and 44% survived for an average 9 months postsurgery. Surgery should not be denied for advanced NSCLC to avoid depriving patients the benefit of curative resection and if resection cannot be achieved then some patients are suitable for adjuvant treatments. 0308: THE USE OF HOMOGRAFTS IN THE OPERATIVE MANAGEMENT OF INFECTIVE ENDOCARDITIS HAS LOWER SHORT AND MEDIUM-TERM MORTALITY AND IMPROVED OVERALL OUTCOME COMPARED TO PROSTHETIC VALVES Abderahman Kamaledeen , Rizwan Q. Attia , James C. Roxburgh , Christopher P. Young , Christopher I. Blauth . King's College London, London, UK; Department of Cardiothoracic Surgery, St Thomas' Hospital, London, UK Aim: Infective endocarditis remains a challenging clinical entity, particularly with changing causative organisms. We aim to characterize the operative management, microbiology, operative mortality and long-term survival in a contemporary cohort of patients having surgery for IE. Methods: We reviewed the records of 125 consecutive patients who had surgery for IE over five years (2006-2011), at a large tertiary cardiovascular centre. The valve prosthesis, causative organism, in-hospital morality, long-term survival and need for repeat surgery were examined. Results: Cumulative Kaplan-Meier survival was 86.8% at one-year and 67.8% at five years. 101/125(80.8%) patients had isolated valve surgery, 13/ 125(13.6%) two valves and 7/125(5.6%) three valves. Of the aortic valve IE, 24/66(36.3%) patients had aortic homograft (LES 44.7%), 33/66(50%) had tissue valve (LES47.7%) and 9/66(13.6%) mechanical prosthesis (LES 23.3%). The use of Homograft as a valve substitute was more common in patients with annular involvement and intracardiac abscesses. In-hospital mortality for homograft was 4.5% vs. 8% for prosthetic valve p0.01. There were no re-infections in the homograft group vs. 4.5% for prosthetic valve p0.001. Conclusion: In patients having operation for infective endocarditis, homograft valve replacement provided excellent short and medium-term outcomes with superior survival and freedom from re-intervention compared with prosthetic valve replacement 0380: THE ROLE OF SURGICAL LUNG BIOPSY IN THE MANAGEMENT OF UNDEFINED PARENCHYMAL LUNG DISEASE Vivienne Blackhall, Felice Granato, Katrina Knight, Bernadette Quinn, Ali Jilaihaiwi, Alan Kirk, Mohammed Asif. Golden Jubilee National Hospital,

Microscopic analysis of glovebox glove failures and breaches

Programmatic operations at the Los Alamos National Laboratory Plutonium Facility (TA-55) involve working with plutonium and other highly toxic, alpha-emitting materials. The spread of radiological contamination on surfaces, airborne contamination, and excursions of contaminants into the operator's breathing zone are prevented using gloveboxes. The TA-55 Glovebox Safety Program augments this passive safety feature. A key element of this program is to perform microscopic analyses of glovebox glove failures and breaches when their causes are unknown. Initial examinations provide little information about the causes of failures and breaches. This has prompted the development of an instrument that permits cross-sections of glove perforations to be studied. This paper discusses the methodology used to perform microscopic analysis of failures and breaches. It presents three case studies in which microscopic analyses have helped to determine the causes of the glove openings.

Occult Glove Perforation During Adult Elective Orthopaedic Surgery

Aim: This prospective study was conducted in Rustaq Regional referral hospital, Oman from 01-3-2004 to 31-2-2007 to study the frequency of occult glove perforation in adult elective orthopaedic operations and to determine the efficacy of double gloving. Material and Methods: A total of 404 gloves (369 double and 35 single ) used in 175 adult orthopaedic operations were examined. All gloves were tested by standardized water leak method – EN 455-1. Glove perforation rate, incidence amony surgical team members, location of perforation and duration of surgery were analysed and compared. Results: The overall perforation rate was found to be 15% with 11.6% blood contamination in our study. Surgeons had higher perforation rate (11.1%) compared to other operating team members.The index finger and thumb of the non-dominant hand had more perforations then the dominant hand. More perforations were observed in bony operations compared to other surgeries. Perforation rate was more in operations lasting for more than 90 min. The perforation rate of unused gloves was 1%. Conclusion: Routine use of double gloves during elective orthopaedic surgery is advocated. Occult perforations are unrecognized during surgery and pose greater risk. Double gloves confers additional protection especially in high risk patients and significantly reduces blood contamination. Also regular glove changing in high risk surgeries and surgeries lasting more than 2 hours is recommended.

Are glove perforations equivalent to sharp injuries: results from a study in maxillofacial surgery

The objective of the present study was to remove the ambiguity in usage of terms Glove perforations (GP) and Sharp injuries (SI) equivalently. A 6 months prospective study was conducted involving the use of double gloving practice for the procedures needing medical sharps in maxillofacial surgery. Total of 270 procedures were performed. GP’s and SI’s were analysed. The data revealed total of 400 GP’s including 290 outer GP and 110 inner GP and 80 SI. Out of 80 SI, 65 were superficial and 15 were deep injuries. Out of total 270 patients, 25 were high risk patients. Only 5 significant exposures were observed which were a part of high risk patient group. This study concludes: Every GP is not always SI but every SI is a GP. Risk of SI increases with inner GP but it is also not necessary that every inner GP leads to SI. A modified surveillance and a new algorithm are also proposed which can be a part of guidelines for occupational safety and health.

Are glove perforations equivalent to sharp injuries: results from a study in maxillofacial surgery

Are glove perforations equivalent to sharp injuries: results from a study in maxillofacial surgery

Blunt versus sharp suture needles for preventing percutaneous exposure incidents in surgical staff.

Surgeons and their assistants are especially at risk of exposure to blood due to glove perforations and needle stick injuries during operations. The use of blunt needles can reduce this risk because they don't penetrate skin easily but still perform sufficiently in other tissues. To determine the effectiveness of blunt needles compared to sharp needles for preventing percutaneous exposure incidents among surgical staff. We searched MEDLINE and EMBASE (until May 2011), CENTRAL, NHSEED, Science Citation Index Expanded, CINAHL, Nioshtic, CISdoc, PsycINFO, and LILACS (until September 2010). Randomised controlled trials (RCTs) of blunt versus sharp suture needles for preventing needle stick injuries among surgical staff measured as glove perforations or self-reported needle stick injuries. Two authors independently assessed study eligibility and risk of bias in trials and extracted data. We synthesized study results with a fixed-effect model meta-analysis. We located 10 RCTs involving 2961 participating surgeons performing an operation in which the use of blunt needles was compared to the use of sharp needles. Four studies focused on abdominal closure, two on caesarean section, two on vaginal repair and two on hip replacement. On average, a surgeon that used sharp needles sustained one glove perforation in three operations. The use of blunt needles reduced the risk of glove perforations with a relative risk (RR) of 0.46 (95% confidence interval (CI) 0.38 to 0.54) compared to sharp needles. The use of blunt needles will thus prevent one glove perforation in every six operations.In four studies, the use of blunt needles reduced the number of self-reported needle stick injuries with a RR of 0.31 (95% CI 0.14 to 0.68). Because the force needed for the blunt needles is higher, their use was rated as more difficult but still acceptable in five out of six studies.The quality of the evidence was rated as high. There is high quality evidence that the use of blunt needles appreciably reduces the risk of exposure to blood and bodily fluids for surgeons and their assistants over a range of operations. It is unlikely that future research will change this conclusion.