Percutaneous injuries during oral and maxillofacial surgery procedures

This study estimated the frequency of percutaneous injuries (Pls) to dental health-care workers during oral and maxillofacial surgery and examined the circumstances surrounding the incidents.

A self-reported, prospective study was conducted to document Pls incurred during oral and maxillofacial surgery performed on outpatients and inpatients over 1-month and 6-month periods, respectively. Among the study variables examined were the numbers of patients treated, number and types of procedures performed, duration of treatment, numbers and types of health care workers at risk, treatment setting, and number of injuries.

Four injuries were recorded during 362 operating room procedures on 236 inpatients, for a rate of 1.1 Pls per 100 procedures (95% confidence interval: 0.3 to 2.8) and 1.7 Pls per 100 patients (95% confidence interval: 0.5 to 4.6). These four injuries occurred during 1,665 person-procedures (mean number of workers present at each procedure times the total number of procedures) for a rate of 0.24 Pls per 100 person-procedures (95% confidence interval: 0.1 to 1.0). Three injuries took place during fracture reductions; two were caused by surgical wire and the third by a needlepoint Bovie tip. One injury occurred during orthognathic surgery and involved a Woodson elevator. Residents recorded no injuries while treating 521 outpatients (0 Pls per 100 patients; 95% confidence interval: 0 to 0.6).

The results support previous findings that Pls rarely occur during outpatients oral and maxillofacial surgery procedures. However, the findings suggest that operating room procedures for oral and maxillofacial surgery that use wire or involve fracture reduction may be associated with an increased risk of injury. Strategies such as using a cork or sponge to cap sharp wires or instruments, and protecting hands and fingers by double gloving, may be used to decrease the risk of Pl.