Human immunodeficiency virus status in facial fracture patients

A prospective study was performed to obtain an indication of the incidence of human immunodeficiency virus (HIV) among the population of facial fracture patients treated at a city hospital in Toronto, Ontario, Canada. This study was stimulated by the observation that a significant number of the patients treated at this unit were drug and alcohol abusers, inmates of a local penitentiary (where homosexual activity is believed not to be uncommon) or had no fixed address. In addition, the surgical treatment of these patients involved the use of sharp, high-powered motorized instruments e.g., saws, drills, wires, etc., and resulted in the spillage and aerosolization of considerable amounts of blood and other tissues. Operating room staff are exposed to these patients for 12 to 18 hours on many occasions. Accidental exposure to body fluids can occur easily. It was thus decided to obtain consented HIV testing of all facial fracture patients managed by the Plastic Surgery Team between July and December 1990. Fifty-two patients were seen, and 47 (90.4%) of them were tested for HIV. Results were obtained for 46 (97.8%) of those tested. One patient (2.2%) was found to be positive for HIV. This figure was smaller than anticipated considering the patient population demographics, but is not an insignificant number and thus it is advised that if any suspicion arises, consented HIV testing should be obtained and the necessary precautions taken.