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Volume 66, Issue 4, Pages 704-710 (April 2008)


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High Incidence of Blood Exposure Due to Imperceptible Contaminated Splatters During Oral Surgery

Kohji Ishihama, DDS, PhDCorresponding Author Informationemail address, Seiji Iida, DDS, PhD, Hidehiko Koizumi, DDS, PhD, Takenobu Wada, DDS§, Tadafumi Adachi, DDS, PhD, Emiko Isomura-Tanaka, DDS, PhD, Tadashi Yamanishi, DDS, PhD#, Akifumi Enomoto, DDS, PhD⁎⁎, Mikihiko Kogo, DDS, PhD††

Purpose

To evaluate the incidence of blood exposure during outpatient oral surgery from splattering caused by use of high-speed rotary instruments at the Referral and Teaching Center, University Dental Hospital.

Materials and Methods

Twenty-five consecutive patients who had impacted mandibular third molars were selected. The attending surgeon wore an operation gown and visor mask, and carried out the tooth extraction with the regular procedure. We counted the number of bloodstains found on the operation gown and visor mask, and confirmed the presence of diluted and invisible bloodstains using a leucomalachite green presumptive test, which was able to detect dilutions up to 1:4,000.

Results

There were 469 separate bloodstains on the gown and visor mask of oral surgeons, which came from 19 (76%) of 25 patients during impacted mandibular third molar surgery. Presumptive tests for invisible bloodstains resulted in 1,206 positive reactions, 2.57-fold greater than the visible stains, from 88% of the cases. All of the surgeons were right-handed and the common areas of staining were the right forearm, face, and thorax regions.

Conclusions

Dental procedures with high-speed instruments exposed surgeons to possible blood-borne infections by splashing in nearly 90% of the cases. Greater than 50% of the stains were invisible to the naked eye. Based on our results, strict compliance with barrier precautions, including routine use of an operation gown and visor mask, is recommended whenever oral surgery is carried out with high-speed rotary instruments.

 Clinical Fellow, First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Suita City, Osaka, Japan.

 Associate Professor, First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Suita City, Osaka, Japan.

 Associate Professor, First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Suita City, Osaka, Japan.

§ Resident, First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Suita City, Osaka, Japan.

 Clinical Fellow, First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Suita City, Osaka, Japan.

 Clinical Fellow, First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Suita City, Osaka, Japan.

# Clinical Fellow, First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Suita City, Osaka, Japan.

⁎⁎ Clinical Fellow, First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Suita City, Osaka, Japan.

†† Professor and Chair, First Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Suita City, Osaka, Japan.

Corresponding Author InformationAddress correspondence and reprint requests to Dr Ishihama: First Department of OMFS, Osaka University Graduate School of Dentistry, 1-8, Yamadaoka, Suita 565-0871, Japan

PII: S0278-2391(07)01510-8

doi:10.1016/j.joms.2007.06.663


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