Blood Contacts During Surgical Procedures

Panlilio, Adelisa L.; Foy, Deretha R.; Edwards, Jonathan R.; Bell, Darren; Welch, Betty A.; Parrish, C. M.; Culver, David H.; Lowry, Philip W.; Jarvis, William R.; Perlino, Carl A.

doi:10.1097/00132586-199112000-00044

Cited by 15 publications

(19 citation statements)

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“…This is similar to results reported by Jagger et al 8 that showed that residents and attending physicians accounted for 36% and 28% of exposures, respectively, and a French study that observed approximately 35% of BBF exposures occurred among surgeons. 16 Consistent with our results, previous studies have shown procedure duration and estimated blood loss to be risk factors [13][14][15]18 ; at least 1 prior study found an association with number of personnel in the surgical field. 15 Also, another prior study has demonstrated differences in BBF exposures rates across surgical services.…”

Section: Resultssupporting

confidence: 91%

“…6,[8][9][10][11][12] Many studies focusing on risk of BBF exposures in operating rooms (OR) have examined the effectiveness of safety measures such as double-gloving, the use of blunt suture needles or other safety devices, and neutral instrument passing zones. 4,[13][14][15][16][17][18][19][20][21][22][23][24] Although some studies have examined the characteristics of the surgical procedures, [13][14][15]18 other studies of BBF exposures have been mostly descriptive, focusing on the distribution of events by categories such as type of exposure, surgical service, occupation, and device type. 6,8,12,[25][26][27] The current study presents descriptive statistics of BBF exposures occurring in the OR and examines properties of the procedures, gathered in administrative data sources, to determine whether these predict the risk of exposure during surgical procedures.…”

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confidence: 99%

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Surgical Procedure Characteristics and Risk of Sharps-Related Blood and Body Fluid Exposure

Myers

Lipscomb

Epling

et al. 2015

Infect. Control Hosp. Epidemiol.

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OBJECTIVETo use a unique multicomponent administrative data set assembled at a large academic teaching hospital to examine the risk of percutaneous blood and body fluid (BBF) exposures occurring in operating rooms.DESIGNA 10-year retrospective cohort design.SETTINGA single large academic teaching hospital.PARTICIPANTSAll surgical procedures (n=333,073) performed in 2001–2010 as well as 2,113 reported BBF exposures were analyzed.METHODSCrude exposure rates were calculated; Poisson regression was used to analyze risk factors and account for procedure duration. BBF exposures involving suture needles were examined separately from those involving other device types to examine possible differences in risk factors.RESULTSThe overall rate of reported BBF exposures was 6.3 per 1,000 surgical procedures (2.9 per 1,000 surgical hours). BBF exposure rates increased with estimated patient blood loss (17.7 exposures per 1,000 procedures with 501–1,000 cc blood loss and 26.4 exposures per 1,000 procedures with >1,000 cc blood loss), number of personnel working in the surgical field during the procedure (34.4 exposures per 1,000 procedures having ≥15 personnel ever in the field), and procedure duration (14.3 exposures per 1,000 procedures lasting 4 to <6 hours, 27.1 exposures per 1,000 procedures lasting ≥6 hours). Regression results showed associations were generally stronger for suture needle–related exposures.CONCLUSIONSResults largely support other studies found in the literature. However, additional research should investigate differences in risk factors for BBF exposures associated with suture needles and those associated with all other device types.Infect. Control Hosp. Epidemiol. 2015;37(1):80–87

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Section: Resultssupporting

confidence: 91%

mentioning

confidence: 99%

Surgical Procedure Characteristics and Risk of Sharps-Related Blood and Body Fluid Exposure

Myers

Lipscomb

Epling

et al. 2015

Infect. Control Hosp. Epidemiol.

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“…For example, of the 99 percutaneous injuries observed by Tokars et al [44] during 1382 surgical operations in five different wards (general, orthopedic, gynecologic, traumatic and cardiac surgery), most (73%) were related with the suturing. Risk factors for percutaneous injuries included the performing an emergency procedure, a patient blood loss greater than 250 mL, and a duration of surgery procedure greater than 1 h [45] . The HBV load in the source patient may influence the risk of transmission of HBV infection to non-immune healthcare workers.…”

Section: Post-exposure Managementmentioning

confidence: 99%

Hepatitis B virus and hepatitis C virus infection in healthcare workers

Coppola

Pascalis

Onorato

et al. 2016

WJH

124

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Approximately 3 million healthcare workers per year receive an injury with an occupational instrument, with around 2000000 exposures to hepatitis B virus (HBV) and 1000000 to hepatitis C virus (HCV). Although an effective HBV vaccine has been available since the early eighties, and despite the worldwide application of universal vaccination programs started in the early nineties, HBV still remains a prominent agent of morbidity and mortality. There is no vaccine to limit the diffusion of HCV infection, which progresses to chronicity in the majority of cases and is a major cause of morbidity and mortality worldwide due to a chronic liver disease. Healthcare workers are frequently exposed by a mucosal-cutaneous or percutaneous route to accidental contact with human blood and other potentially infectious biological materials while carrying out their occupational duties. Mucosal-cutaneous exposure occurs when the biological material of a potentially infected patient accidentally comes in contact with the mucous membranes of the eyes or mouth or with the skin of a healthcare worker. Percutaneous exposure occurs when an operator accidentally injures himself with a sharp contaminated object, like a needle, blade or other sharp medical instrument. About 75% of the total occupational exposure is percutaneous and 25% mucosal-cutaneous, the risk of infecting a healthcare worker being higher in percutaneous than in mucosal-cutaneous exposure. All healthcare workers should be considered for HBV vaccination and should meticulously apply the universal prophylactic measures to prevent exposure to HBV and HCV.

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“…10,11 Surgeons and surgical residents are usually at higher risk for PIs than other operating room personnel. [12][13][14][15][16] Makary and colleagues 17 found that by their final year of training, 99% of surgical residents had had a needle-stick injury. Despite high PI rates, PI underreporting among surgeons remains the highest among hospital workers.…”

mentioning

confidence: 99%

Surgeons’ and residents’ double-gloving practices at 2 teaching hospitals in Ontario

Haines

Stringer

Herring

et al. 2011

cjs

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Background: Surgeons and residents are at increased risk of exposure to blood-borne pathogens owing to percutaneous injury (PI) and contamination. One method known to reduce risk is double-gloving (DG) during surgery.Methods: All surgeons and residents affiliated with the University of Western Ontario (UWO) and McMaster University in 2005 were asked to participate in a Web-based survey. The survey asked respondents their specialty, the number of operations they participated in per week, their age and sex, the proportion of surgeries in which they double-gloved (DG in ≥ 75% surgeries was considered to be routine), and the average number of PIs they sustained per year and whether or not they reported them to an employee health service. Results:In total, 155 of 331 (47%) eligible surgeons and residents responded; response rates for UWO and McMaster surgeons were 50% and 39%, respectively, and for UWO and McMaster residents, they were 52% and 47%, respectively. A total of 43% of surgeons and residents reported routine DG; 50% from McMaster and 36% from UWO. Using logistic regression to simultaneously adjust for participant characteristics, we confirmed that DG was more frequent at McMaster than at UWO, with an odds ratio of 3.32 (95% confidence interval 1. 35-8.17). Surgeons and residents reported an average of 3.3 surgical PIs per year (2.2 among McMaster participants and 4.5 among UWO participants). Of the 77% who reported at least 1 injury/year, 67% stated that they had not reported it to an employee health service. Conclusion:Percutaneous injuries occur frequently during surgery, yet routine DG, an effective means of reducing risk, was carried out by less than half of the surgeons and residents participating in this study. This highlights the need for a more concerted and broad-based approach to increase the use of a measure that is effective, inexpensive and easily carried out.

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Blood Contacts During Surgical Procedures

Cited by 15 publications

References 0 publications

Surgical Procedure Characteristics and Risk of Sharps-Related Blood and Body Fluid Exposure

Surgical Procedure Characteristics and Risk of Sharps-Related Blood and Body Fluid Exposure

Hepatitis B virus and hepatitis C virus infection in healthcare workers

Surgeons’ and residents’ double-gloving practices at 2 teaching hospitals in Ontario

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