Trottmann F, Mojon D
University Bern, Bern, Switzerland.
Klin Monbl Augenheilkd. 2013 Feb;230(2):150-6. doi: 10.1055/s-0032-1327957. Epub 2013 Jan 20.
Accidental sharp injuries among the health-care workers are frequent, especially in the surgical disciplines. Because there are only limited data available about accidental sharp injuries in small surgical disciplines, we investigated the occurrence of sharp injuries among ophthalmosurgeons in Switzerland.
An anonymous questionnaire was sent to all 500 members of the Swiss Ophthalmological Association. We asked how often the surgeons or any member of the surgical team suffered injury during an ophthalmic surgery within the last 2 years and which instrument had caused the injury. Using linear regression we analysed the connection between the occurrence of injuries and various factors, e.g., the age or experience of the surgeon, whether any actions in the case of an injury were taken, whether the event was documented and whether actual guidelines were followed.
In the 117 analysed questionnaires we counted 193 injuries. 42.7 % of the surgeons (n = 50, 95 % CI 33.7 % - 51.8 %) had injured themselves at least once during the past two years and 59.8 % of the surgeons (n = 70, 95 % CI 50.9 % - 68.7 %) reported injuries among the rest of the surgical team. On average, surgeons were injured 0.66 times in two years (range 0-4 injuries per person). Most injuries were caused by hollow needles [28.2 % of self injuries (95 % CI 18.2 % - 38.2 %)], 24.3 % of injuries of team members (95 % CI 16.5 % - 32.1 %). 53.0 % of the surgeons (n = 63, 95 % CI 44.0 % - 62.0 %) reported the case whereas 18.8 % (n = 22, 95 % CI 11.7 % - 25.9 %) never reported them. Some questionnaires did not contain the answers to those last questions. Using chi-square, we could observe more injuries in the middle-age section and in surgeons with 11-30 years of surgical experience (p < 0.05). The regression did not show any dependence on the rate of injuries on the surgeon's experience and the number of performed surgeries.
We conclude that in ophthalmosurgery sharp injuries to surgeons or their surgical team happen frequently and only about 50 % of the cases are reported. This study shows that there is room for improvement concerning the documentation and the actions taken after an injury. Thereby potential sources of danger could be better monitored.
医护人员意外锐器伤屡见不鲜，在外科领域尤为如此。由于关于小型外科领域意外锐器伤的可用数据有限，我们对瑞士眼科医生的锐器伤发生情况进行了调查。
向瑞士眼科协会的所有500名成员发送了一份匿名问卷。我们询问外科医生或手术团队的任何成员在过去2年内的眼科手术中受伤的频率以及导致受伤的器械。我们使用线性回归分析了受伤发生情况与各种因素之间的联系，例如外科医生的年龄或经验、受伤时是否采取了任何措施、事件是否有记录以及是否遵循了实际指南。
在117份分析的问卷中，我们统计到193起受伤事件。42.7%的外科医生（n = 50，95%置信区间33.7% - 51.8%）在过去两年中至少受伤一次，59.8%的外科医生（n = 70，95%置信区间50.9% - 68.7%）报告手术团队其他成员有受伤情况。外科医生平均两年受伤0.66次（每人受伤次数范围为0 - 4次）。大多数损伤是由空心针造成的[自我伤害的28.2%（95%置信区间18.2% - 38.2%）]，团队成员受伤的24.3%（95%置信区间16.5% - 32.1%）。53.0%的外科医生（n = 63，95%置信区间44.0% - 62.0%）报告了该病例，而18.8%（n = 22，95%置信区间11.7% - 25.9%）从未报告过。一些问卷没有包含这些最后问题的答案。使用卡方检验，我们可以观察到中年组和有11 - 30年手术经验的外科医生受伤情况更多（p < 0.05）。回归分析未显示受伤率对外科医生经验和手术例数有任何依赖性。
我们得出结论，在眼科手术中，外科医生或其手术团队的锐器伤频繁发生，且只有约50%的病例被报告。本研究表明，在受伤后的记录和采取的措施方面有改进空间。从而可以更好地监测潜在的危险来源。
