When one considers the broad range of procedures and treatment techniques in the surgical and healthcare field that require sharp instruments, it seems inevitable that injuries are bound to occur to the hospital staff handling these items. A study reported by the National Institute for Occupational Safety and Health (NIOSH) estimates the number of sharps and needlestick injuries to range from 600,000 to 800,000 annually. The high end of that estimate would cover ten percent of all healthcare workers in the USA.

The Qlicksmart family of products ensures the safety of surgeons as well as healthcare workers downstream.

The danger of these types of injuries is two-fold. While the actual physical injury from a needlestick may be minimal, the chance of infection from a used and contaminated needle is very great. On the other hand, while a scalpel injury may not carry a high risk of infection, the possibility of artery, nerve or tendon damage that could require microsurgery and extensive rehabilitation is far greater. In either case, the wound or infection resulting from a sharps injury can have a devastating effect on the unlucky recipient.

To address these risks and protect the invaluable healthcare workforce, a number of surgical instrument and medical device manufacturers and marketers have begun to develop and supply safety equipment to reduce the risk of injury from sharps. From scalpels to IV introducers, a variety of recent design innovations are enabling surgeons and nurses to keep blades and needles under wraps during instrument transfer and disposal. Following is a selection of the latest technologies now available to protect OR personnel and those downstream from potentially deadly sharps injuries.

Scalpel Safety

The Bard-Parker™ Protected Blade Systems from BD (Franklin Lakes, NJ) feature durable, reusable metal handles and protected surgical blades. These safety scalpels help to minimize the risk of surgical blade injury before and after use without compromising standard technique. Specifically designed with the weight and feel that clinicians prefer, the scalpels provide convenient and easy one-handed activation of the protective shield.

The TechnoCut Plus safety scalpel from MYCO Medical stores the scalpel blade within the handle when not in use.

The scalpel system offers a unique, clear locking shield with a top activation button for easy left- or right-handed activation. The button’s audible click and tactile sensation confirm that the lock is in place. The blade remains covered during both assembly and disposal to help prevent accidental contact with the blade. Blade assembly and disassembly are quick and easy, requiring no extra steps.

The Bard-Parker Protected Blade System is now available with size 20 thru 23 protected surgical blades in a compatible size-four safety handle. The company also offers the same safety shield design in a full line of disposable scalpels, all of which comply with OSHA standards and federal regulations.

Shippert Medical Technologies Corp. (Centennial, CO) markets the extensive line of DeRoyal Retractable Safety Scalpels. Designed by cardiovascular surgeons and safety engineers, the scalpels protect healthcare professionals from injury and infection caused by accidental cuts from exposed scalpel blades. These safety scalpels offer the comfort styling for a variety of hand positions and allow one-hand opening and retraction of the surgical blade for repeated protection during procedures. An audible and tactile “click” helps to identify blade’s open and locked position.

The DeRoyal Scalpels are available with stainless steel Swann Morton Blades in size 10, 11 and 15 to accommodate nearly 95 percent of all surgical procedures. The scalpels also feature ribbed finger grips to ensure slip resistance in gloved hands. To improve sharps safety in the sterile field, the fully visible blade position is detectable at all times. In addition, the scalpel’s highly visibility biohazard-red color prompts proper disposal in a dedicated sharps container.

The Qlicksmart Flask is the world’s first single handed scalpel blade remover.

Shippert also offers convenient, disposable scalpel holders to accommodate safe scalpel handling and transfer. The holders maintain scalpels in a “blade-down” position to reduce the chance of injury. These sterile holders accommodate up to three scalpels and readily adhere to a mayo stand or back table cover.

Sandel Medical Industries, LLC (Chatsworth, CA) has developed a broad approach to sharps safety for the surgical arena. Their complete “Total Sharps Safety System” is comprised of three specially designed safety products: The disposable Weighted Safety Scalpel™, the Z-Tray™ instrument transfer tray and the Z-Instrument Drape™ for safe instrument placement.

The Weighted Safety Scalpel is disposable, but provides the weight of a reusable scalpel so as not to compromise the tactile feel and sharpness demanded by surgeons. It features a locking and unlocking safety shield which can be activated using the left or right hand and produces an audible click. The scalpels also come with the company’s TimeOut® removable sleeves which provide a convenient reminder to comply with JCAHO’s universal protocol.

The Z-Tray and Stretch-A-Tray for the hands-free transfer of sharps in the surgical field are bright orange in color which makes them very noticeable. They are equipped with adhesive strips on the bottom to help them stay on the sterile field. The oval shaped sides and staggered bottom allows for easy pick up of sharps. Also orange in color is the Z-Instrument Friction Drape which provides a highly visible “neutral zone” for all types of sharp instruments on or off the sterile field.

All three of these products comply with OSHA, JCAHO and AORN regulations and are designed to help OR personnel create and use a hands-free technique during handling, use and transfer of sharp instruments between the surgeon and other scrubbed personnel. Sandel also offers a Safety Assessment for any healthcare facility which only takes a few moments. This Safety Assessment can bring awareness of safety issues in the healthcare facility.

The latex-free Surshield Safety Winged Blood Collection and Infusion Sets offer easy one-handed activation.

The TechnoCut Plus safety scalpel from MYCO Medical (Cary, NC), when used properly, reduces the spread of infection by storing the used or dirty surgical blade locked away in the handle by retracting prior to disposable. During passing, the TechnoCut Plus retracts into the handle ruling out opportunities for accidental injuries. The scalpel is top activated for easy right or left handed use, and features a “final lock” feature that permanently locks the blade away in the sheath to prevent re-use. A series of convenient audible clicks indicate the extended, retracted and final lock blade positions. Blade size is easily confirmed by the color-coded slider on top of the scalpel. In addition, the scalpel features a non-slip, ribbed handle for improved dexterity and excellent tactile feel.

Qlicksmart Pty Ltd, an Australian R&D medical device company recently developed the world’s first single handed scalpel blade remover, the Qlicksmart Flask. Soon after, the Qlicksmart line was expanded to include the Qlicksmart Single with a reusable metal holder known as the Peacock and the Qlicksmart Cassette 3-in-1 which has a simple built-in holder. Both of these devices are designed specifically for use in the sterile field in the OR.

Developed as “Mistake Proofing Devices,” the Qlicksmart family of products has a number of proprietary features that ensure the safety of both the surgeon and the healthcare workers downstream. These devices act as a sharps bin in their own right by housing the used scalpel blade after it is removed. They offer single-handed operation or single-handed activation and are based on the Passive Safety principle in which the safety feature activates automatically, as opposed to Active Safety devices where the end-user has to consciously activate the safety mechanism.

The disposable Weighted Safety Scalpel is part of Sandel Medical’s “Total Sharps Safety System.”

These devices are also very intuitive and easy to use. Qlicksmart Flask incorporates a patented guidance mechanism so that it is very easy to use. It meets the old adage “see one, do one, teach one” and arguably requires no training other than the picture directions on the front face. The Qlicksmart Sterile range requires a little more dexterity, but the devices were designed to be used by the very dexterous operating room nurses. Still, expertise requires only one use under supervision. (The Qlicksmart product line is marketed by MYCO Medical.)?

Needlestick Prevention

In addition to their extensive selection of scalpel safety products, MYCO Medical also offers a line of needlestick prevention products. The VAKU 8 Plus Safety Blood Collection Sets incorporate an OSHA compliant shielded needle that provides one-handed activation. The shield is designed to maximize wing flexibility, yielding superior tactile feel, ease of use and enhanced patient comfort. As the needle is withdrawn from the patient, the shield covers the dirty needle protecting staff from accidental contact. The needle, at this point, is secure and ready for disposal without concern of injury to downstream staff. Uniquely packaged to minimize tube coiling and memory, the sets are 100 percent latex-free and constructed with kink-resistant PVC tubing and preassembled multiple sample luers. The VACU 8 Plus sets are offered in a variety of needle gauges.

The SharpShield™ Safety Syringe from Devon Medical, Inc. (King of Prussia, PA) allows for single-hand injection requiring virtually no change in standard techniques. The safety device passively activates sub-epidermally when a form-fitted sheath slides over the needlepoint after the medicine is administered. This occurs before the needle is removed from the patient, so the healthcare workers and patient are never exposed to a contaminated needle. After use, the plunger locks to ensure one-time use and that the syringe will stay safe throughout disposal process. Unlike auto-retractable syringes, SharpShield does not cause blood splatter upon activation or removal.

The Bard-Parker Protected Blade System from BD features a durable, reusable metal handle and protected surgical blades.

Terumo Medical Corporation (Somerset, NJ) provides a variety of safety solutions for hypodermic and infusion products. Specifically, their SurGuard2™ safety needles and syringes and Surshield™ Safety Winged Needle Sets comply with the latest OSHA regulations on Bloodborne Pathogen safety, with built-in safety features to reduce the risk of needlestick injury.

The SurGuard2 safety needles and syringes come in 18 sizes of needles and 18 sizes of syringes and offer a number of unique features. They provide one-handed activation for ease of use as well as bevel alignment with the safety sheath, which is especially helpful for TB and other low angle injections. Plus, the standard SurGuard2 hub fits all Luer Lock and Luer Slip syringes.

The Surshield Safety Winged Blood Collection and Infusion Sets also offer one-handed activation. These latex-free sets require no change in needle insertion technique. Once the needle has been used and removed from the patient, the attached safety shield is easily engaged and provides visual confirmation that the needle is covered.

The care and safe practices that healthcare workers exhibit in the OR and beyond remain the greatest protection against sharps injury, but no matter how careful one my be, accidents will happen. In that regard, the recent developments in sharps safety and needlestick prevention equipment are providing surgeons and nurses across the spectrum of healthcare a definite and positive advantage.