Mechanisms of glove tears and sharp injuries among surgical personnel

Article Abstract:

It is necessary to develop methods for reducing the risk of transmitting human immunodeficiency virus (HIV) and other blood-borne pathogens to health care workers. (HIV is the causative agent of AIDS.) Operating room personnel have a high risk of contact with contaminated blood. A surgeon's cumulative life-time risk of seroconversion (evidence of antibody response to the presence of HIV) has been estimated to be as high as 1 to 10 percent. In order to design preventive strategies, a better understanding is needed of how exposure occurs. A study was undertaken to classify the mechanisms of glove tears and injuries resulting from sharp objects as they occur in the operating room. Over a three-month period at a large teaching hospital, all glove tears and sharp injuries occurring in the operating room were reviewed. The injured person was interviewed immediately after the incident by a nurse. During 2,292 operations, 249 glove tears and 70 injuries from sharp objects were documented. In 63 percent of the glove tears, there was visible contact with the patient's blood. The cause of the glove tear could only be identified in 81 incidents (33 percent). Ninety-two percent of the glove tears occurred when personnel were wearing one glove; 67 percent of the sharp injuries were caused by needle sticks, usually during suture placement. The majority of the sharp injuries (57 percent) occurred with injured the hand stationary or holding an object (11 percent); while the hand was retracting tissue (12 percent); and by instruments not in use (17 percent). These findings suggest that most glove tears are the result of unknown causes; however, changes in gloves or the number of gloves worn may reduce risk. Knowing the mechanism of sharp injuries should lead to the development of effective preventive strategies aimed at protecting operating room personal from exposure to blood-borne pathogens. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Research, Evaluation, Injuries, Occupational health and safety, Occupational safety and health, Prevention, HIV infection, HIV infections, HIV (Viruses), HIV, Disease transmission, Rubber gloves, Gloves (Surgery), Nosocomial infections, Cross infection, Blood-borne diseases, Bloodborne diseases, Operating room personnel

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Gastroenterology

Article Abstract:

The association of Helicobacter pylori (H. pylori) bacteria with duodenal ulcers, improved mortality rates with colon cancer screening, projected advances in the molecular detection of cancers and the increasing use of laparoscopic cholecystectomy for treatment of gallstones are covered in a brief discussion of recent gastroenterological studies. H. pylori is present in the gastrointestinal tract of about 50% of adults in the US. Treatment to eradicate the organism has been shown to reduce the frequency of ulcer recurrence. The mortality rate from colon cancer was reduced by 70% in a 1992 study of sigmoidoscopic screening. Advances in the field of molecular biology may soon allow practitioners to identify a molecular marker associated with increased risks of colon cancer. Laparoscopic cholecystectomy is a less invasive technique for removing gallstones than traditional open surgery. However, there is still no conclusive evidence that it is safer than the traditional approach.

Practice, Gastroenterology

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Why are cholecystectomy rates increasing?

Article Abstract:

The large increase in laparoscopic cholecystectomies prompts the question of whether this new procedure actually benefits patients or if their gallstones could be left untreated. Laparoscopic cholecystectomy is a minimally invasive procedure for removing the gallbladder. A 22% increase in the number of these operations was found among Medicare patients in Pennsylvania. Open cholecystectomy, a more invasive surgery, is used for patients with severe gallbladder disease. Complications from surgery, such as injury to the bile duct, can occur, so the decision to operate should be based on whether the gallstones are causing the symptoms. Pain from gallstones is intense but not frequent. Elective cholecystectomy should be offered after other possible reasons for the symptoms are eliminated.

Care and treatment, Editorial, Usage, Gallstones, Cholecystectomy

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