Risk of transmission of blood-borne viral infection in orthopaedic and trauma surgery

Lemaire, R; Masson, Jean‐Bernard

doi:10.1302/0301-620x.82b3.0820313

Cited by 19 publications

(20 citation statements)

References 52 publications

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“…[1,2,6]. Perforations can increase the risk of surgical-site infection, and expose the surgeon to blood-borne diseases such as HIV, hepatitis C virus, and hepatitis B virus [10,14]. Understanding the clinical situations in which perforations occur can aid the surgeon in taking steps to minimize the risk of infection to the patient and to minimize the risk of viral exposure to the surgeon.…”

Section: Introductionmentioning

confidence: 99%

High Risk of Surgical Glove Perforation From Surgical Rotatory Instruments

Goldman

Haug

Owen

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Surgical gloves can be damaged during the course of a procedure, which can place the surgeon and patient at risk. Glove perforation may not always be readily apparent, and determining the risk factors for glove perforation can aid the surgeon in deciding when a glove change is advisable. Time of wear and needle sticks have been well studied; however, other mechanisms including mechanical stress from surgical equipment have had limited evaluation to date. Questions/purposes We evaluated the risk of glove perforation in gloves that were caught in a surgical rotatory device (such as drills and reamers). The aims of our study were (1) to determine the percentage of undetected microperforations after entanglement on a rotatory tool during orthopaedic procedures, (2) to determine which kinds of rotatory devices most commonly cause such microperforations, and (3) to assess whether time of wear had an effect on the risk of perforation. Methods From July 2014 to September 2015, 33 gloves were obtained from all orthopaedic subspecialties at our Level I trauma center if they were caught in a rotatory device greater than one revolution. Time of glove wear and location of the glove that was caught in a rotatory device were recorded. After an evaluation for macroperforations (C 5 mm), the gloves were evaluated for microperforations (\ 5 mm) via the American Society for Testing and Materials (ASTM) one-liter load test. Time of wear was compared among gloves with macroperforations, microperforations, and no perforations. Results The 33 gloves obtained came from 33 procedures. Seventeen of 33 (52 %) gloves had perforations. Seven of the 17 perforated gloves had macroperforations while 10 had microperforations. Eleven of 33 entanglements were caught by drills, nine by reamers, eight by Kwires, and the remaining five gloves were caught by various other instruments. Eight of 17 perforations were caused by drills, three by reamers, three by K-wires, and three by various other instruments. The average time of wear was 58 minutes which did not differ with pattern of glove damage.

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Section: Introductionmentioning

confidence: 99%

High Risk of Surgical Glove Perforation From Surgical Rotatory Instruments

Goldman

Haug

Owen

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…The third stage is AIDS -in which there are clinical manifestations and the potential for contamination is much greater than in the chronic, asymptomatic phase [4].…”

Section: Discussionmentioning

confidence: 99%

“…Available evidence suggests that occupational risk of HIV transmission is low [4,10]. However, there is the view that there is underreporting [4,11].…”

Section: Discussionmentioning

confidence: 99%

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The Orthopaedic Surgeon and HIV in Jamaica

Fletcher¹

2015

MOJOR

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The Caribbean has one of the higher prevalence rates of HIV in the world. Many HIV patients present to the Orthopaedic surgeon as a trauma victim. Trauma continues to be very prevalent as a result of interpersonal violence and motor vehicle accidents. This continues to drain the health budget, deplete blood banks and cause cancellations on elective lists. Orthopaedic surgeons continue to be at risk because a large percentage of their patients present with trauma. Factors affecting cumulative risk include the HIV prevalence in the practising community, the prevalence of trauma nearby communities, the nature and length of surgery as well as adherence to universal precautions.

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“…have caused CreutzfeldteJakob disease 9,10 Although HIV virus is the most present in the media, Hepatitis B virus (HBV) is the most prevalent and as such carries more risks for transmission. 7,11 Procedures have been developed to ensure the supply of safe bone. 2,12 These procedures include guidelines on donor selection, tissue quarantine and tissue processing.…”

Section: Introductionmentioning

confidence: 99%