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Suture needle handling in the operating theatre; what is the safest method? A survey of surgical nursing opinion
  1. Georgina J Williams1,
  2. Marios Nicolaou1,
  3. Thanos Athanasiou2,
  4. David Coleman1
  1. 1Department of Plastic Surgery, John Radcliffe Hospital, Oxford, UK
  2. 2Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK
  1. Correspondence to Dr Georgina J Williams, Department of Plastic Surgery, John Radcliffe Hospital, Oxford OX3 9DU, UK; georginawilliams{at}


Introduction Suture needle handling methods vary extensively between units. Securing the needle tip by locking it against the shaft of the needle holder prior to transfer (protected method) has been suggested to improve safety, although this is not evidence based. Some teams prefer to transfer the needle mounted perpendicularly to the needle holders with the tip exposed (unprotected method). We investigated scrub nurses’ preferred method of needle transfer, and noted the safety of each by investigating their experience of needlestick injuries (NSIs).

Method Scrub nurses from Oxford University Hospitals Trust, Chelsea and Westminster and Wexham Park Hospitals were surveyed anonymously between November 2013 and August 2014. Nurses selected their preferred method (protected, unprotected or either), and indicated previous NSIs with either technique. Multinomial regression analysis and χ2 with Yates correction were used to assess associations.

Results One hundred and seven scrub nurses from 12 specialities were interviewed. 80/107 (75%) preferred protected transfer, 20/107 (19%) preferred unprotected transfer and 7/107 (6%) expressed no preference. There was no significant association between needle-mounting preference and years of scrub experience or speciality. Significant differences between preferences and four of the six hospitals were observed. Nine (9/107, 8%) scrub nurses reported NSIs with the protected method compared with 40 (40/107, 37%) in the unprotected group, this difference being statistically significant (p<0.001, χ2=25.17). Five (5/107, 5%) reported NSIs with both methods.

Conclusions Protected needle transfer seems safer than the unprotected method. Needle-handling guidelines and appropriate training are required to help prevent the occurrence of NSIs in the operating theatre.

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