Needle stick and sharp injuries during surgical procedures: an ignored danger?

Abstract

Handling of needles and sharp instruments expose the surgeons to sharp injuries, which can transmit blood borne pathogens such as HIV, Hepatitis B and C. Obstetrics and Gynaecology has been shown to carry the highest risk on this regard for medical students during their training. Universal precautions have been described to prevent such disease transmission, but their effectiveness during surgical training has not been evaluated. In this study we assessed the frequency of such injuries among undergraduates, surgical and gynaecology post graduate trainees (PG trainees) and the theatre nursing staff at Teaching Hospital, Ragama. The procedures that exposed them to injury and the measures taken following the injury were also evaluated. Study was carried out from January to March, 2006 and the participants were asked to recall such injuries during their career and in the preceding year. Data were collected using a self administered questionnaire. Eighty medical students, 33 post graduate trainee medical officers, and 29 nursing officers were included in the study. The proportion suffered from such injuries during their carrier among medical students, PG trainees and nurses were 66%, 94%, and 82%. Within the preceding year it was 53%, 82% and 52% respectively. The mean frequency of injuries in the last year among PG trainees was significantly higher than medical students and nurses (3.1 vs. 1.67, 1.64; P<0.001). Assisting at major surgery caused the highest number of injuries to both PG trainees and nurses while repairing of episiotomy was the commonest procedure among medical students. A high proportion of members in all categories had received Hepatitis B vaccination. The actions taken following these injuries were inappropriate in a vast majority of participants. We conclude that needle stick and sharp injuries among surgical trainees is very common. Steps need to be taken to protect the individuals from serious blood borne pathogens.