Stitely Michael L, Close Jessica, Ferda Aaron, Mehra Suwan, Malson Brian, Hembree Wanda
Dept. of Women's and Children's Health, Dunedin Hospital and Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
W V Med J. 2013 Sep-Oct;109(5):32-6.
To compare the rate of glove perforations and surgeon satisfaction when utilizing blunt surgical needles compared to conventional sharp surgical needles.
Patients undergoing Caesarean delivery were randomly assigned to the use of blunt or sharp surgical suture needles. Surgical team members reported any known needlesticks or perforations of gloves and the primary surgeon completed a survey to gauge their satisfaction with the needles. Glove perforation was assessed by suspending gloves and filling with water. The chi-square test was used to assess categorical variables and the Mann-Whitney U-test was used to assess ordinal data.
A total 240 patients were enrolled into the study. There was no statistically significant difference in the rate of glove perforation per case between groups assigned to sharp (24%) or blunt surgical needles (26%). (RR 1.05, 95% CI 0.68-1.63). There were significant differences in the surgeon satisfaction surveys, with surgeons in the sharp needle group being more satisfied with the tissue penetration of the needle (p < .001), needle integrity (p = .01), force to penetrate tissue (p < .001) and control of bleeding at the needle insertion site (p = .001). Surveys from surgeons in the blunt needle group showed a statistically significant improvement in the perceived safety profile of the blunt needles (p < .001) CONCLUSIONS: There was no significant difference in the rate of glove perforation between blunt and sharp surgical needles during Caesarean delivery. Overall surgeons were more satisfied with the sharp surgical needles.
比较使用钝头手术针与传统尖头手术针时手套穿孔率及外科医生的满意度。
将接受剖宫产的患者随机分配使用钝头或尖头手术缝合针。手术团队成员报告任何已知的针刺伤或手套穿孔情况，主刀医生完成一项调查以评估他们对手术针的满意度。通过悬挂手套并注水来评估手套穿孔情况。采用卡方检验评估分类变量，采用曼-惠特尼U检验评估有序数据。
共有240例患者纳入本研究。分配使用尖头手术针（24%）或钝头手术针（26%）的组间每例手套穿孔率无统计学显著差异（相对危险度1.05，95%可信区间0.68 - 1.63）。在外科医生满意度调查方面存在显著差异，尖头手术针组的外科医生对针的组织穿透性（p <.001）、针的完整性（p = 0.01）、穿透组织的力度（p <.001）以及针插入部位的止血控制（p = 0.001）更满意。钝头手术针组外科医生的调查显示，钝头手术针在感知安全性方面有统计学显著改善（p <.001）。结论：剖宫产过程中钝头和尖头手术针的手套穿孔率无显著差异。总体而言，外科医生对尖头手术针更满意。
