Authors' objectives:

To identify and assess the efficacy and effectiveness of devices and procedures designed to lower the incidence of scalpel injuries in the operative setting, through a systematic review of the literature.

Authors' results and conclusions: A total of 19 studies were included in this review: 13 examining cut-resistant gloves and glove liners; three assessing the hands-free passing technique; one reporting on protective footwear; one investigating the feasibility of sharpless surgery and one evaluating a single-handed scalpel blade remover. Seven of these studies were randomised trials (NHMRC Level II), three were non-randomised comparative studies (Level III-2), two were comparative studies with historical controls (Level III-3), one was a Level IV study and seven were experimental studies to which the NHMRC Hierarchy of Evidence could not be applied.

Authors' recommendations: On the basis of the evidence presented in this systematic review, the ASERNIP-S Review Group agreed on the following classifications and recommendations concerning scalpel safety in the operative setting: Evidence rating The evidence base in this review is rated as poor, limited by the quantity and quality of the available evidence. Specific limitations of the evidence included the diversity of interventions and outcomes considered, the lack of a standard comparator and the differences in clinical settings and experimental environments in which the interventions were employed. Effectiveness and efficacy Effectiveness outcomes were considered for those interventions that were undertaken in clinical settings, and efficacy outcomes for those undertaken in laboratory settings: Cut-resistant gloves & glove liners, hands-free passing technique, sharpless surgery, pass tray & single-handed scalpel blade remover Based on the published literature, the effectiveness of cut-resistant gloves and glove liners, the hands-free passing technique, sharpless surgery, and the combination of a pass tray & single-handed scalpel blade remover in the clinical setting cannot be determined. Cut-resistant gloves & glove liners and protective footwear Based on the published literature, the efficacy of cut-resistant gloves and glove liners and protective footwear in experimental settings cannot be determined.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.surgeons.org/asernip-s/publications.htm

Year Published: 2007

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Australia

Organisation Name: Australian Safety and Efficacy Register of New Interventional Procedures-Surgical

Contact Address: ASERNIP-S 24 King William Street, Kent Town SA 5067 Australia Tel: +61 8 8219 0900

Contact Name: racs.asernip@surgeons.org

Contact Email: racs.asernip@surgeons.org

Copyright: Australian Safety and Efficacy Register of New Interventional Procedures -Surgical (ASERNIP-S)