外科手術中に血と接触した場合
A L Panlilio1, D R Foy, J R Edwards
1Hospital Infections Program, Centers for Disease Control, Atlanta, GA 30333.
JAMA
|March 27, 1991
まとめ
手術室のスタッフは,血液との接触によって感染のリスクに直面しています. ほとんどの血液接触,特に外科医の接触は,バリア対策の強化と改善された外科手袋によって予防できます.
科学分野:
- ヘルスケア関連感染症とは
- 手術における労働の安全性について
- 手術室での感染対策について
背景:
- 手術室 (OR) のスタッフは,血液の接触によって血経由の病原体感染に敏感です.
- これらの被曝の頻度と性質を理解することは,リスク軽減に不可欠です.
研究 の 目的:
- ORスタッフが経験する血液接触の頻度と種類を定義する.
- これらの血液暴露に関連した特定の危険因子を特定するために.
- 強化されたバリア対策による予防の可能性を評価する.
主な方法:
- 訓練された観察者は,6つの外科部門で206の手術を将来的に監視しました.
- 収集されたデータには,個別の手続きごとに血液接触の数と種類が含まれていました.
- 統計分析により,リスク要因と潜在的な予防措置が特定されました.
主要な成果:
- 血の接触は手術の30.1%で発生し,147件の血の接触を伴う人手術の5.3%で発生しました.
- 外科医は,血液と接触する頻度が最も高い (18.6 件/100 件).
- 外科医の主要なリスク要因には,緊急処置,>250mLの失血,およびORの持続時間>1時間が含まれていました. 多くの曝露は,よりよい障壁によって防ぐことができた.
結論:
- ORにおける血液接触の有意な割合は予防可能である.
- 強化されたバリア対策 (例えば,顔面シールド,耐性ガウン) と改善されたグローブ技術が示されています.
- 手術技術の再評価により,職業的曝露のリスクがさらに軽減される可能性があります.
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