PERCUTANEOUS INJURIES DURING ORAL AND MAXILLOFACIAL SURGERY PROCEDURES

Purpose: This study estimated the frequency of percutaneous injuries ( Pls) to dental health-care workers during oral and maxillofacial surge ry and examined the circumstances surrounding the incidents. Material and Methods: A self-reported, prospective study was conducted to docum ent Pls incurred during oval and maxillofacial surgery performed on ou tpatients and inpatients over 1-month and 6-month periods, respectivel y. Among the study variables examined were the numbers of patients tre ated, number and types of procedures performed, duration of treatment, numbers and types of health care workers at risk, treatment setting, and number of injuries. Results: Four injuries were recorded during 36 2 operating room procedures on 236 inpatients, for a rate of 1.1 Pls p er 100 procedures (95% confidence interval: 0.3 to 2.8) and 1.7 Pls pe r 100 patients (95% confidence interval. 0.5 to 4.6). These four injur ies occurred during 1,665 person-procedures (mean number of workers pr esent at each procedure times the total number of procedures) for a ra te of 0.24 Pls per 100 person-procedures (95% confidence interval. 0.1 to 1.0), Three injuries took place during fracture reductions; two we re caused by surgical wire and the third by a needlepoint Bovie tip, O ne injury occurred during orthognathic surgery and involved a Woodson elevator. Residents recorded no injuries while treating 521 outpatient s (0 Pls per 100 patients; 95% confidence interval, 0 to 0.6). Conclus ion: The results support previous findings that Pls rarely occur durin g outpatient oral and maxillofacial surgery procedures. However, the f indings suggest that operating room procedures for oral and maxillofac ial surgery that use wire or involve fracture reduction may be associa ted with an increased risk of injury. Strategies such as using a cork or sponge to cap sharp wives or instruments, and protecting hands and fingers by double gloving, may be used to decrease the risk of Pi.