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Blood-Borne Viruses and Surgery - Assessment and Control of Transmission

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Blood-borne diseases are transmitted through contact with infected blood, and surgeons are at higher risk while performing a surgical procedure.

Medically reviewed by

Dr. Shubadeep Debabrata Sinha

Published At December 27, 2022
Reviewed AtJanuary 31, 2023

Introduction:

Blood-borne viruses are infection-causing viruses that spread through the blood involving hepatitis B, hepatitis C, and human immunodeficiency virus (HIV). The human immunodeficiency virus can induce Acquired Immuno-deficiency Syndrome (AIDS) if left untreated. The most acceptable method to safeguard yourself from blood-borne viruses is to evade contact with any other person's blood. A major hazard for acquiring blood-borne viruses is via injecting drugs. Human immunodeficiency viruses and hepatitis B are transmitted sexually. Disclosures to blood and other products or discharges like body fluids happen in broad types of occupations.

What Are Blood-Borne Viruses?

Blood-borne viruses are viruses transmitted through the blood or any type of body fluid having blood. Blood-borne viruses involve hepatitis B and C viruses, HIV and AIDS viruses. They are also transmitted through broken skin, membranes, or blood exposure to these viruses. It may happen through the treatment procedure with re-usage of unsterilized medical equipment, surgical instruments, transfusion of blood or its products, tattoos, or any other procedure involving body piercing done with unsterilized tools. Exchanging the drug injecting instruments mostly happens in drug addicts. Blood-borne viruses can also be transmitted through unprotected sex. The most acceptable method to safeguard yourself from blood-borne viruses is to evade contact with any other person's blood. Human immunodeficiency viruses and hepatitis B are transmitted sexually.

Who Are at High Risk of Blood-Borne Viruses?

Healthcare workers, emergency response persons, public protection personnel, and additional health workers can be disclosed to blood or byproducts via needlestick, sharps damages, mucous membranes, and skin vulnerabilities. The pathogens of direct consideration are the human immunodeficiency virus, hepatitis B virus, and hepatitis C. Employees and staff should benefit from available engineering management and work patterns to avert blood and other bodily fluids disclosure.

What Is Needle Stick Injury?

Needle stick injuries are injuries occurring from sharp surgical instruments. These include sharp instruments used in surgeries like syringes, scalpels, and lancets.

How the Surgical Injury Is Assessed?

  • The healthcare professionals treating the surgical blood-borne infection will initially check the lesion. A thorough medical history should be taken. It includes the time of injury, type of injury, how the injury happened, and the patient's medical history with whom the sharp instruments or the needle has been used.

  • Blood samples should be taken and sent for laboratory investigation of diseases like hepatitis B, C, or human immunodeficiency virus.

  • Other diseases also have a lesser risk of transmission through blood and other body fluids. These involve cytomegalovirus and Epstein-Barr viruses which induce glandular fever.

  • If needed, the healthcare professional will recommend taking blood samples of the patient. It is useful in the diagnosis of the disease and helps the treatment procedure. But it can only be done if the patient is willing to do so.

How to Control the Transmission of Blood-Borne Diseases?

The chances of people getting infected by a blood-borne virus during surgical procedures are high, considering the direct contact of the surgeon with an infected patient. For instance, it is estimated that more than three million people in the United States are chronically contaminated with the hepatitis C virus, a potentially infectious disease.

Based upon existing data and recommendations provided by the Centers for Disease Control and Prevention, the following indications regarding hepatitis disease:

  • Relevant to All Blood-Borne Pathogens - Surgeons should resume using the highest infection control criteria, implicating the adequate known hygienic barriers, universal precautions, and scientifically acknowledged standards to control blood exposure. This approach should expand to all regions where surgical care is generated and should involve safe handling practices for needles and sharp instruments. During every procedure, utmost action should be exercised to control patients' vulnerability to the blood of the surgical team members and guard the surgical team against vulnerability to the blood of patients.

  • Relevant to All Potentially Infected Patients - Surgeons have the identical righteous responsibility to effect care to hepatitis-infected patients as they have to manage other patients.

  • Relevant to Hepatitis B (HBV) -Surgeons should know their hepatitis B immunization and antibody status. Operators with acquired antibodies from flourishing immunization are shielded from forthcoming infection and are not contagious to their patients. Doctors with natural antibodies to hepatitis B have had previous infections and should know whether they are positive for the antigen of hepatitis B. If they are negative for the hepatitis B-surface antigen, they do not have chronic infection and cannot communicate it to patients. If they favor the hepatitis B virus-surface antigen, they should experiment with the e-antigen of the hepatitis B virus. Suppose they are positive for the Hepatitis B virus-surface antigen but are negative for the e-antigen. In that case, they can resume their medical routine but should consult talented medical guidance for their healthiness. Consider the chronically infected hepatitis B virus surgeon is positive for e-antigen or has increased viral counts in their blood. In that case, a masterful panel should be assembled to suggest resuming clinical practice. Such a panel should involve infectious disease specialists and surgeons with good knowledge of virus blood-borne transmissions. The e-antigen-positive surgeon and the panel should confer and settle on a plan for rescuing patients at hazard for disease communication. A recent clinical examination into possible antiviral treatments for chronic hepatitis B virus infection may lead to efficacious therapies in the prompt future. Chronic hepatitis B virus-infected surgeons should have talented medical guidance on developing therapies for the objectives of their healthiness.

Surgeons who are not vaccinated and do not have an earlier infection with the hepatitis B virus, that is, there are no antibodies to the hepatitis B virus, should be vaccinated for hepatitis B virus. Documentation of seroconversion to a favorable antibody test for the surface antibody of the hepatitis B virus should be accepted one month after the realization of the immunization procedure. Loss to seroconvert should cause a second attempt at immunization. Not being able to respond should be understood by doctors so that maximum usage of techniques to control blood disclosure may be utilized to bypass prospective blood contact.

  • Relevant to Hepatitis C (HCV) - Surgeons should know their antibody class for hepatitis C virus infection. Surgeons who are negative for hepatitis C virus antibodies are at hazard for hepatitis C virus infection and should utilize all methods to control blood disclosure in the future. Surgeons with chronic hepatitis C virus infection have no cause to change their approach based on existing knowledge. They should aim for talented medical guidance because existing treatments with interferon-alfa and ribavirin can successfully manage this infection in some patients.

Conclusion:

Immunization against hepatitis B virus disease is a considerably influential process of controlling the spread of hepatitis B virus from patients to associates of the surgical group, and surgeons, thus, should be immunized against the hepatitis B virus. Such immunization is a considerably influential way to decrease the hazard of transmission of the hepatitis B virus from surgeons to patients.

Recent treatments may cause in-therapy for the hepatitis B virus-infected surgeon. Control of hepatitis C virus infection is only achievable via blood exposure control. Surgeons should understand their infection status for hepatitis C infection so that adequate treatment may be launched. The hepatitis B virus and hepatitis C virus infection situation of the surgeon is a personal health report and is personal. The American College of Surgeons and its relevant representatives will resume observing the data and correct these suggestions to safeguard public safety and rescue surgeons.

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Dr. Shubadeep Debabrata Sinha
Dr. Shubadeep Debabrata Sinha

Infectious Diseases

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