Practical Precautions for Avoiding Sharp Injuries and Blood Exposure

Ec, Smoot

doi:10.1097/00006534-199802000-00045

Cited by 20 publications

(22 citation statements)

References 11 publications

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“…A striking result was that up to 21% of the glove failures were undetected until the moment the gloves were taken off. Though lower than in previous studies, which have indicated that the surgeon is unaware the glove is perforated in more than 50% of such occurrences [18,21,23,26,27], particular concern remains over occult blood exposure through intimate skin contact for lengthy periods of time [28].…”

mentioning

confidence: 60%

Surgeon‐patient barrier efficiency monitored with an electronic device in three surgical settings

et al. 2001

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Blood-borne viral pathogens are an occupational threat to health care workers (HCWs), particularly those in the operating room. A major risk is posed by accidental penetrating injury, but skin contamination with body fluids from an infected patient, with prolonged intimate cutaneous contact, is a frequent occurrence during surgery, carrying further risk of transdermal infection. We have monitored barrier failure in three surgical settings (microsurgery, orthopedic surgery, general surgery) by means of an electronic surveillance device. A total of 111 surgical procedures were monitored: 67 microsurgeries, 22 orthopedic surgeries, and 22 general surgeries. Of the 278 electronic alarms signaling barrier failure, 44 (15.8%) were associated with glove perforation, 39 of which (88.6%) were not perceived by the operator. In 16 of those, the skin was visibly stained with the patient's blood. Altogether, 76 of the alarms (27.3%) were consequent to contacts caused by soaked gowns/sleeves, and 121 (43.5%) were attributed to hydration of latex porosities; 37 alarms (13.4%) were unexplained false positives. On only one occasion did a surgeon observe blood stains on his hands without a previous alarm; this event was classified as a device failure due to incorrect wiring. Double-gloving offered satisfactory protection against skin contamination during microsurgery but not during orthopedic surgery. The data presented here indicate that electronic monitoring of the surgical barrier enables prompt detection of barrier failure, especially at the level of the gloves, thereby limiting skin contamination with patients' body fluids during surgery.

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confidence: 60%

Surgeon‐patient barrier efficiency monitored with an electronic device in three surgical settings

et al. 2001

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“…4 Smoot reported that "most students indicate that they do not see routine universal precautions undertaken by staff and residents, and no requirement for the compliance is enforced". 28 Around 60% of NSIs were not reported by dental students. Non-reporting of NSIs is a contentious issue within the dental profession the most common reason for that was the student's lack of knowledge that all injuries had to be reported.…”

Section: Discussionmentioning

confidence: 99%

A survey of needle sticks and other sharp injuries among dental undergraduate students

Jaber

2011

Int. j. infect. control

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Health-care workers (HCWs) including dental students are at occupational risk of exposure to blood-borne viruses (BBV) following needle sticks and sharp injuries (NSIs). The purpose of this study was to determine the prevalence of NSIs among dental students and evaluate the circumstances in acquiring such injuries. A survey was carried out of all clinical dental students in the College of Dentistry, Ajman University of Science and Technology, United Arab Emirate (UAE) by means of an anonymous self-administered questionnaire that asked questions on demography, number, type, level of knowledge of inoculation injuries and associated risks of exposure to BBV, management and reporting of such exposures. Of 230 dental students that responded to the questionnaire (response rate of 92 percent), 64 (27.9%) were males and 166 (72.1%) were females, 132 (57.3%) were 4 th year students and 98 (42.7%) from 5 th year students. Of the total sample, 53 students reported having had an inoculation injury, resulting in a 0.23 sharp injury events per student per year. Recapping a needle, administering local anesthesia and performing scaling and polishing procedures were the most important causes of NSIs among dental students (60.3%, 32/53). Despite a comprehensive educational programme and training for dental students, knowledge of inoculation injuries and associated issues remained inadequate. The findings of this study confirm that dental students experience NSIs but are not likely to report them, thus it is important that the principles of infection control training and reporting of all NSIs continue to be emphasized throughout undergraduate dental education.

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“…One study has also suggested that double gloving offers protection against skin contamination in microsurgical procedures (Hentz et al, 2001). A comfortable method of latex double gloving consists of wearing a one half-size larger than the normal inner glove, with a normal glove as the second layer (Smoot, 1998). Wearing indicator gloves allows the wearer to detect perforations to the outer gloves more easily (Tanner and Parkinson, 2004).…”

Section: Hand Protectionmentioning

confidence: 99%

“…It is safer to ''instrument tie'' suture knots. It is also advisable to avoid tying knots with short suture lengths when the needle is still attached, as this may result in a needle puncture of the palm (Smoot, 1998).…”

Section: Surgical Techniquementioning

confidence: 99%

Hand Surgery on Patients Who Are “High Risk” For Blood-Borne Viruses

Al-Ani

Mohan

Platt

2006

Journal of Hand Surgery

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There is a risk of transmission of blood-borne viruses (BBV) to health-care workers when performing hand surgery on intravenous drug abusers and other patients known to have BBV. This review summarises methods and procedures that may be employed to help reduce this risk to a minimum. High-risk patients should be identified early and a non-invasive procedure considered. Only experienced staff should scrub and appropriate clothing should be worn. Sharp instrument use should be kept to a minimum and only instrument retraction and suturing should be employed. When possible, wounds should be closed with staples, glue or absorbable sutures. Appropriate steps must be taken to reduce the risk of injuries from sharp bone ends, K-wires and splash exposure during irrigation.

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Practical Precautions for Avoiding Sharp Injuries and Blood Exposure

Cited by 20 publications

References 11 publications

Surgeon‐patient barrier efficiency monitored with an electronic device in three surgical settings

Surgeon‐patient barrier efficiency monitored with an electronic device in three surgical settings

A survey of needle sticks and other sharp injuries among dental undergraduate students

Hand Surgery on Patients Who Are “High Risk” For Blood-Borne Viruses

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