[HIV infection in the operating room conditions]

Several cases of occupational HIV transmission during surgical procedures have been reported all over the world in the last few years. Orthopaedic surgeons are at particularly high risk for blood contamination and skin injuries. This article addresses the risk of HIV transmission in the surgical setting with a focus on specific risk factors: the prevalence of the infection in general population, the stage of the disease, virulence, inoculum size, the nature and frequency of blood contacts. It also shows how the last two factors depend on surgical specialty, duration and kind of the procedure, role of each person, number of needles used and amount of blood loss. The recommended safer surgical techniques as well as personal protective equipment are presented as the strategy to prevent health care worker--to patient transmission. The importance of compliance with universal precautions is pointed as a way to achieve a successful outcome in preventing infection with HIV.