Accidental injuries and blood exposure to cardiothoracic surgical teams

A survey was undertaken over a 15-week period (62 working days) to find out the incidence and common mechanism of accidental injuries and blood exposure in cardiothoracic surgical teams. Two hundred and seventy events were reported: 70% glove penetrations, 18% skin punctures, 4% non-bleeding skin lesions and 8% lacerations with bleeding. Eye splashes occurred in 14% of the cases. The risk to the team was higher for cardiac surgery (1.6) than for thoracic surgery (0.5) and endoscopy (0.01). Most of the events were self-inflicted by experienced personnel. The surgeon's left index finger was most frequently injured, and the majority of the injuries were caused by needles followed by wire injuries during sternal closure. Prevention should be directed towards a safer technique for sternal closure, and protection of the surgeon's hands, especially his left index finger, should be found. Eye protection with goggles should become routine. This study demonstrates that open heart procedures carry a high risk of injury and frequent exposure to blood increasing the risk to the surgical team of acquiring viral infections (hepatitis-B and HIV) from the patients.