Blood contacts during surgical procedures

Article Abstract:

Surgeons and other operating room personnel are at risk for infection with a number of diseases, including hepatitis B virus, human immunodeficiency virus (HIV), and others that are spread through contact with infected blood. With the increased illness and mortality associated with hepatitis B, and the advent of the deadly HIV virus (which causes AIDS), it is important to determine the risk to hospital personnel and institute preventive measures. Previous studies of injury rates among hospitals have noted widely varying overall rates, as well as widely varying rates for each service. A study of surgical services was undertaken at an inner-city hospital where there were always at least 50 inpatients with HIV or AIDS. Among the services were general surgery, trauma, orthopedics, burn, gynecology, and plastics. Researchers observed 3,280 surgeries. The risk of blood contact was greater for surgeons when patient blood loss was greater than 250 ml., when the operation lasted longer than one hour, and during emergency, burn and orthopedic surgery. Skin contact with blood, including soaking of garments, was the most frequent type of contact, and probably the least risky, but HIV transmission by skin contact has been documented. It is also the easiest type of contact to prevent using gloves and other protective clothing, especially for anesthesia and circulating personnel. Prevention of contact through injuries to the skin will require the use of surgical techniques and instruments that minimize the risk, and such barriers as puncture-resistant gloves. Face shields, head hoods, and other additional protective measures may be indicated for especially high-risk procedures. Preoperative HIV antibody screening of surgical patients has been proposed, but its usefulness has not been demonstrated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Safety and security measures, Medical personnel, Communicable diseases, Disease transmission, Protection and preservation

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Percutaneous injuries during surgical procedures

Article Abstract:

Surgeons can reduce the risk of exposing a patient to their blood if they wear puncture-resistant gloves, use forceps to hold tissue that is being sutured, and change to a sterile needle if they stick themselves inadvertently. Researchers who observed 1,382 surgical procedures found that 99 injuries occurred in 95, or seven percent, of the procedures. Seventy-seven percent of the injuries were needle-stick injuries that occurred while the surgeon was suturing tissue. The injury was most often to the tip of the forefinger on the non-dominant hand, and almost half the injuries occurred because the surgeons held the tissue with the fingers of their other hand while suturing. After 21 of the injuries, the surgeon continued to use the needle for suturing, although the surgeons were never observed to be bleeding into the patient's wound.

Methods, Injuries, Statistics, Wounds and injuries, Surgeons

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A survey of occupational blood contact and HIV infection among orthopedic surgeons

Article Abstract:

The number of orthopedic surgeons who are infected with HIV may be relatively low, even though many have frequent contact with a patient's blood. Of 3,420 orthopedic surgeons surveyed at a meeting, 87% had come in contact with a patient's blood and 39% had been cut during a procedure within the past month. Almost two-thirds had operated on a person with known risk factors for HIV infection in the past year, and three percent had been cut and exposed to the blood of a patient known to be infected with HIV during their career. Each surgeon donated a blood sample during the meeting, which was tested for HIV. Only two surgeons tested positive, and both had other risk factors for HIV infection that were not related to their profession. Nevertheless, surgeons should follow universal precautions to protect themselves from HIV infection.

Health aspects, Risk factors, HIV infection, HIV infections, Orthopedic surgery, Orthopedists

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