Navigation Links
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 s are associated with certain types of operations.

The researchers also found that the operations associated with the greatest risk of infection - lymph-node biopsy, soft-tissue-mass excision and abscess-drainage cases - were often assigned to the most inexperienced surgeons-in-training, placing them at greatest risk.

"Sharpless surgical techniques combined with traditional precautions and early education for surgery trainees are the most practical ways to reduce the risk of infection to health care workers," said Makary.

The researchers studied 709 consecutive adult general surgery operations performed between July 2003 and June 2004 in the community surgical service at The Johns Hopkins Hospital including inpatient, emergency department and outpatient surgical procedures. Data were collected on HIV, hepatitis B and hepatitis C test results, type of operation, age, sex and history of intravenous drug use.

The researchers found that 38 percent of all operations involved a bloodborne pathogen, and almost half (47 percent) of all men tested positive for at least one infection. HIV accounted for 26 percent of infections, hepatitis B for 4 percent, hepatitis C for 35 percent, and co-infection with HIV and hepatitis C accounted for 17 percent of infections. In addition, bloodborne pathogen infection was found in up to 65 percent of patients with a history of intravenous drug use and in as many as 71 percent of patients undergoing a soft-tissue abscess procedure or lymph-node biopsy.

While the patients in this study tend toward low socioeconomic status and increased substance use, most university hospitals in the United States are located in urban areas and serve a similar patient population, added Makary.

Other authors on the report are Eric S. Weiss, Theresa Wang, Dora Syin, Peter Pronovost, David Chang and Edward Cornwell III.


Source:Johns Hopkins Medical Institutions

Related biology news :

1. Rare surgery performed to remove pancreas, prevent diabetes
2. 3D ultrasound device poised to advance minimally invasive surgery
3. For one Stanford doctor, the beat goes on during open-heart surgery
4. Unique equine cataract surgery offered on routine basis
5. Cheaper and simpler keyhole surgery
6. Robot assisted surgery more accurate than conventional surgery
7. U of MN uses robotic surgery techniques in cardiac cell therapy research
8. New biologic treatment for tennis elbow may replace surgery for chronic sufferers
9. Jefferson scientists find high glucose before surgery raises risk of dangerous complications
10. Successful lung cancer surgery not enough to break nicotine dependence in many smokers
11. Computer scientists unravel language of surgery
Post Your Comments:

(Date:11/10/2015)... YORK , Nov. 10, 2015 ... to behavioral biometrics that helps to identify and ... fraud. Signature is considered as the secure and ... the identification of a particular individual because each ... more accurate results especially when dynamic signature of ...
(Date:11/4/2015)... York , November 4, 2015 ... a new market report published by Transparency Market Research "Home ... Growth, Trends and Forecast 2015 - 2022", the global home ... US$ 30.3 bn by 2022. The market is estimated ... forecast period from 2015 to 2022. Rising security needs ...
(Date:10/29/2015)... JOLLA, Calif. , Oct. 29, 2015  The ... a new report titled, "DNA Synthesis and Biosecurity: Lessons ... well the Department of Health and Human Services guidance ... issued in 2010. --> ... but it also has the potential to pose unique ...
Breaking Biology News(10 mins):
(Date:12/1/2015)... ... December 01, 2015 , ... Park Systems , world ... scanning ion conductance microscopy module to Park NX10 that is the only product ... SICM benefits virtually all materials characterization that require measurements in liquid such as ...
(Date:12/1/2015)... Texas (PRWEB) , ... December ... ... , a leading relationship marketing company specializing in scientifically backed, age-defying products, ... January 2016 issue, which highlights the exponential success and unrivaled opportunities that ...
(Date:12/1/2015)... Calif. , Dec. 1, 2015 Cepheid ... of its participation at the Piper Jaffray Healthcare Conference ... this morning, the Company is reaffirming its outlook for ... for 2016, in addition to discussing longer term business ... and Chief Executive Officer.  "We continue to be the ...
(Date:12/1/2015)... ... December 01, 2015 , ... The American Society of Gynecologic ... Kyle Mathews will join fellow surgeons in the shared pursuit of “advancing ... experienced urogynecologist, founder of Plano Urogynecology Associates and Fellow of the American ...
Breaking Biology Technology: