It should be a no-brainer. Everyone uses a safety-engineered safety sharps device and the era of sharps injury will be at an end. Or perhaps not?

There are many sources for sharps, ready and able to inflict a wound and perhaps transmit infection including those discarded by people who inject drugs. They will, inevitably, be at the end to the queue when funding for safety sharps is being considered, which is perhaps rather bizarre since the highest risk receives the lowest priority.

Of course, even with safety sharps there is a risk of injury and infection during use, and during disposal of those devices which are not fully automatic and which rely on some user action to engage the safety feature.

Choosing a product is a complex matter that must be fully risk assessed. Does it offer protection to the user and to others? Does it perform as well as or better that the conventional product that it will replace? Is the look and feel acceptable to users? Does it cost more, or need any different storage facility or dispensers?

The key question is, do it protect?

This is generally considered a foregone conclusion. Based on design attributes manufacturers will claim a great degree of protection to users though evidence if generally lacking. The manufacturer alone cannot provide that data though they might, but probably won’t, support its collection.

Regrettably, when that data is lacking many healthcare professionals carry on regardless happy to believe that a safety-engineered device is safe without any objective evidence to support that opinion. Now, a Canadian group has investigated the use of safety scalpels in the operating theatre.

They conclude that there is insufficient evidence to support regulated use of safety scalpels. Instead, or more reasonably, in addition, injury-reduction strategies should emphasize proven methods including double gloving, blunt suture needles and use of hands-free sharps transfer.

As with most things, training and technique are of great importance. Safety sharps are only one part of a complex issue. There is no need to believe the claims made by safer sharps manufacturers, and great care must be taken to ensure users do not relax in their approach to sharps safety.

DeGirolamo KM, Courtemanche DJ, Hill WD, Kennedy A, Skarsgard ED. Use of safety scalpels and other safety practices to reduce sharps injury in the operating room:  What is the evidence? Can J Surg  2013; 56(4):263-9