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Published on: March 9, 2017
Detection of Visually Imperceptible Blood Contamination in the Surgical Area Using Luminol Among Different Oral
Kohila V Kannan1, Saravanan Kandhasamy1, Reena R John1
1Oral and Maxillofacial Surgery, Vinayaka Mission's Sankarachariyar Dental College, Vinayaka Mission's Research Foundation, Salem, IND.
Abstract:
Introduction Oral surgeons often encounter a significant occupational risk of exposure to potentially harmful infectious diseases during minor oral surgical procedures. These diseases can be transmitted through direct contact with body fluids and aerosolized splatters that may not be visibly detectable. The likelihood of transmission is heightened for clinicians, healthcare workers, and patients alike. The reported prevalence of exposure to blood-borne infections in this field is as high as 90%, with half of these exposures being visually imperceptible. Aim The aim was to detect visually imperceptible blood contamination on personal protective equipment (PPE) and clinical surfaces using the chemiluminescence agent luminol during oral surgical procedures. Materials and methods Thirty minor oral surgical procedures were performed in the Oral and Maxillofacial Surgery Department after obtaining approval from the Institutional Ethics Committee (IEC), Vinayaka Mission's Sankarachariyar Dental College, Vinayaka Mission's Research Foundation, Salem, India. The surgeon, assistant, patient, and clinical surfaces (comprising 15 subsites within the surgical field) wore PPE. The PPE was scrutinized for traces of visually imperceptible blood contamination using luminol. The results of blood splatter on PPE and clinical surfaces in different oral surgical procedures between the non-aerosol and aerosol groups of different durations were analyzed statistically using the chi-square test with p < 0.05 considered significant. Results We observed that visually imperceptible blood contamination in non-aerosol procedures was detected on the assistant PPE kit (46.7%, n = 14), assistant face shield (40%, n = 12), suction apparatus (50%, n = 15), wall (30%, n = 9), and floor (56.7%, n = 17), in both aerosol and non-aerosol procedures. The p-value has been considered statistically significant at p < 0.05 between both the groups (aerosol and non-aerosol). Conclusion Our study results confirmed the presence of undetected blood spillage during aerosol procedures of 30 minutes and non-aerosol surgical procedures of more than 30 minutes over an area of 3.1 feet horizontally and 4.8 feet vertically. So, we strongly emphasize that PPE kits and face shields are mandatory for both surgeon and assistant while performing oral surgical procedures in order to prevent the risk of cross infections, proper infection prevention control protocol for the clinical surfaces also needs to be followed as a standard protocol in all operations.
Insights
Visually imperceptible blood contamination is common during oral surgery, even on personal protective equipment (PPE) and surfaces. Luminol detection highlights the need for enhanced infection control protocols and mandatory PPE use to prevent cross-infection risks.
Area of Science:
- Oral and Maxillofacial Surgery
- Infection Control
- Biomedical Engineering
Background:
- Oral surgeons face significant occupational risks from infectious diseases transmitted via body fluids and aerosols.
- Blood-borne infection exposure in oral surgery can reach 90%, with much contamination being visually undetectable.
Purpose of the Study:
- To detect visually imperceptible blood contamination on personal protective equipment (PPE) and clinical surfaces during oral surgical procedures using luminol.
- To assess the extent and location of blood spillage in both aerosol-generating and non-aerosol-generating procedures.
Main Methods:
- Thirty minor oral surgical procedures were conducted, with PPE and surfaces monitored using the chemiluminescence agent luminol.
- Statistical analysis (chi-square test) compared blood splatter in aerosol and non-aerosol groups, with p < 0.05 considered significant.
Main Results:
- Undetected blood contamination was found on assistant PPE (46.7%), face shields (40%), suction apparatus (50%), walls (30%), and floors (56.7%).
- Significant blood spillage was confirmed in both aerosol and non-aerosol procedures, extending horizontally up to 3.1 feet and vertically up to 4.8 feet.
Conclusions:
- The study confirms significant, undetected blood spillage during oral surgical procedures, emphasizing the risk of cross-infection.
- Mandatory use of PPE, including face shields for surgeons and assistants, and strict adherence to clinical surface infection control protocols are crucial.
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