Archive June 2017 XVIII, No. 6

Let's Get Serious About Sharps Safety

I'm on a quest to eliminate cuts and needlesticks from the OR. Are you ready to join me?

Mark Davis

Mark Davis, MD, FACOG


sharps injuries WATCH OUT Document sharps injuries and near misses, and use them as learning opportunities.

My career-defining moment occurred as I was performing a hysterectomy on a patient I knew quite well. At some point during the surgery, I nicked my finger with a scalpel. Blood was everywhere. Mine mixed with hers, and there was significant risk of cross contamination. I approached her in recovery to discuss the incident.

"Sorry to bother you with this," I said, "but I cut myself during the surgery and I'm here to test you for HIV." Her response buckled my knees.

"You know," she said, "I've been meaning to ask for that test, because I recently found out my husband is an IV drug user."

I had a wife and 2 young children at home, and at the time there were no effective therapies available for HIV, so you can imagine the dark thoughts that raced through my mind during the 4-hour wait for the test result. Thankfully, it was negative.

But that near miss forever changed my views on sharps safety and drove home the importance of doing all I can to protect myself, my colleagues and my patients. That meant adopting blunt suture needles and safety scalpels. It also meant double-gloving and hands-free instrument passing. Here's how you can incorporate those technologies and techniques into your routine and eliminate sharps injuries from your ORs, something I stress to the facility leaders and surgeons I work with as a surgical safety consultant.

Irresponsible SHARP CRITICISM Dr. Davis's latest book, Irresponsible, holds surgeons accountable to sharps safety practices (

1 Blunt suture needles
Blunt suture needles hit the market soon after my HIV scare and I began using them in every procedure. The first generation of needles was frankly too blunt; you had to really push to get the suture through fascia. Surgeons, including me, voiced their frustrations to the needle manufacturers, who made improvements so now you don't have to push any harder than you would with traditional needles to pass suture through internal tissue. In fact, when I was trying to convince my partners to use blunt suture needles, I'd secretly hand them one during surgery and they'd continue working without realizing that it wasn't a conventional needle.

Blunt suture needles were extremely helpful to me during episiotomies. Consider that, during closing, I had to place the first stitch at the apex of the episiotomy incision in the posterior vagina while working through significant amounts of blood and amniotic fluid. That initial suture essentially needed to be placed by feel, and it needed to be placed quickly. It was during that difficult step that I suffered most of the needlesticks I sustained — I estimate about 150 sticks in my 30 years of practice before using blunt suture needles, and none during 10 years of surgery after making the switch. Surgeons still have to be careful when working with the latest blunt suture needles, but the safety devices protect against drawing blood from glancing blows that can puncture 1 or 2 layers of gloves.

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