Kannan Kohila V, Kandhasamy Saravanan, John Reena R, Chinnakutti Suresh
Oral and Maxillofacial Surgery, Vinayaka Mission's Sankarachariyar Dental College, Vinayaka Mission's Research Foundation, Salem, IND.
Cureus. 2024 Feb 8;16(2):e53821. doi: 10.7759/cureus.53821. eCollection 2024 Feb.
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 < 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%, = 14), assistant face shield (40%, = 12), suction apparatus (50%, = 15), wall (30%, = 9), and floor (56.7%, = 17), in both aerosol and non-aerosol procedures. The has been considered statistically significant at < 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.
引言
口腔外科医生在进行小型口腔外科手术时，经常面临接触潜在有害传染病的重大职业风险。这些疾病可通过直接接触体液和气溶胶飞溅物传播，而这些飞溅物可能无法肉眼察觉。临床医生、医护人员和患者感染的可能性都有所增加。据报道，该领域血源性感染的暴露率高达90%，其中一半的暴露是肉眼无法察觉的。
目的
目的是在口腔外科手术过程中，使用化学发光剂鲁米诺检测个人防护装备（PPE）和临床表面肉眼无法察觉的血液污染。
材料与方法
在获得印度塞勒姆维奈亚卡使命研究基金会维奈亚卡使命桑卡拉查里亚牙科学院机构伦理委员会（IEC）的批准后，口腔颌面外科进行了30例小型口腔外科手术。外科医生、助手、患者以及临床表面（包括手术区域内的15个子部位）均穿戴了个人防护装备。使用鲁米诺对个人防护装备进行检查，以寻找肉眼无法察觉的血液污染痕迹。使用卡方检验对不同持续时间的非气溶胶组和气溶胶组在不同口腔外科手术中个人防护装备和临床表面上的血液飞溅结果进行统计分析，P < 0.05被视为具有统计学意义。
结果
我们观察到，在气溶胶和非气溶胶手术中，非气溶胶手术中肉眼无法察觉的血液污染在助手个人防护装备套件（46.7%，n = 14）、助手面罩（40%，n = 12）、吸引装置（50%，n = 15）、墙壁（30%，n = 9）和地面（56.7%，n = 17）上均有发现。两组（气溶胶组和非气溶胶组）之间P < 0.05被认为具有统计学意义。
结论
我们的研究结果证实，在水平3.1英尺、垂直4.8英尺的区域内，30分钟的气溶胶手术和超过30分钟的非气溶胶手术过程中存在未被检测到的血液溢出。因此，我们强烈强调，在进行口腔外科手术时外科医生和助手必须佩戴个人防护装备套件和面罩，以防止交叉感染风险，在所有手术中还需要遵循针对临床表面的适当感染预防控制方案作为标准方案。
