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Scalpel-free surgery could reduce risk of HIV and hepatitis exposure for health care workers

While the incidence of disease from HIV and hepatitis is increasing in the United States, little is known about their prevalence in patients undergoing surgery. Now, researchers have shown that nearly 40 percent of surgeries at The Johns Hopkins Hospital occur in patients who tested positive for a bloodborne germ.

"While these rates are alarming, they are not entirely unexpected. General precautions have been in effect for some time to prevent the spread of disease to health care workers in the operating room," said Martin A. Makary, M.D., assistant professor of surgery and public health at Johns Hopkins and lead author of a report in the May 2005 issue of the Annals of Surgery.

"Given the high incidence of these infections, however, we have developed new strategies such as 'sharpless' surgery-a surgical technique which uses high-technology alternatives to needles and knives. We advocate using these techniques whenever possible in high-risk settings to further protect health care workers from accidental transmission," added Makary.

Sharpless surgical techniques include laparoscopy, electrocautery to replace scalpel incisions, and skin clips or glue instead of sewing to close or repair wounds.

Previous studies have shown that health care workers are injured in about 7 percent of operations. As many as 87 percent of surgeons will receive an injury that breaks the skin -- thus allowing for possible disease transmission - at some point in their career. There are an estimated 40,000 new cases of HIV each year, and hepatitis C is increasing at an even faster rate, according to the report. The study concludes that by studying the rates of HIV and hepatitis B and C among patients presenting for surgery, a more accurate incidence of disease is measured within a community, bypassing the selection bias of traditional statistics of known infected patients presenting to primary care clinics. Furthermore, the authors report that blood-borne pathogen
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Source:Johns Hopkins Medical Institutions


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