Occupational risks of infection in the surgical management of trauma patients.

The evolution of the acquired immunodeficiency syndrome secondary to the human immunodeficiency virus (HIV) has resulted in increased concern by surgeons and other members of the health care team with respect to occupationally acquired viral infections. Hepatitis B, hepatitis C, and other viral infections of the liver remain more important than HIV as a cause of morbidity and death for surgeons. Reduction in risk of these infections for surgeons can be achieved by hepatitis B vaccination, better utilization of personal protective equipment, and by improved techniques in the performance of procedures. An overall enhanced awareness in the use of sharp instruments in the operating room is most important. Finally, serologic testing of patients prior to operative procedures, or of surgeons as a condition to performing procedures is an expensive and counterproductive exercise that cannot be recommended.