Suture Needle Injuries During Wound Closure: Examining Sources of Distraction in the OR

Despite focus on prevention of needlestick injuries, intraoperative injuries involving suture needles have increased in the past two decades. When interruptions occur during surgery, a practitioner's focus is disengaged, creating an "error space;" re-engagement of the practitioner takes exponentially longer as each subsequent interruption occurs during the procedure. Human factors studies focus on the interaction between individuals and the environment in which they work (eg, processes, equipment). Researchers use a human factors approach to understand distractions during surgery. Using this methodology, wound closure is viewed as a standalone process and the effect of distractions and interruptions on suture needle injuries is examined. Competing priorities combined with interruptions present opportunities for altered situational awareness, which can lead to injury. This article redefines wound closure as a vulnerable time with great potential for error-a time during which distractions and interruptions can lead to suture needle injuries and other unexpected outcomes.