Skip to main content
PMC home page
Annals of The Royal College of Surgeons of England logoLink to Annals of The Royal College of Surgeons of England
. 1990 Sep;72(5):281–286.

The response of general surgeons to HIV in England and Wales.

A T Stotter 1, M N Vipond 1, P J Guillou 1
PMCID: PMC2499186  PMID: 2221760

Abstract

The prevalence of HIV in the UK has been estimated to be 1 in 1000 of the population. Surgeons are at particular risk of occupational transmission from infected blood. To determine the effect of HIV on surgical practice we sent a questionnaire to 681 general surgeons in England and Wales; 450 replied (66%). Of those who replied, 42% were aware of having operated on an HIV-infected patient at least once, and 28 had recognised self-injury in such circumstances; 79% attempted to identify HIV-infected patients preoperatively, though many depended on clinical suspicion alone, which is known to be unreliable. Of those who had operated on a seropositive patient, 90% reported taking special precautions to avoid blood contact and minimise sharps injuries for such cases. The majority wore double gloves, eye protection and fluid-resistant gowns, but only a minority reported changes in surgical technique. Half had made no changes in procedures or technique when operating on patients not identified as being at risk of HIV infection. Among a wide variety of comments made by the surgeons, the commonest was a call for facilitation of HIV testing prior to surgery. This survey indicates that surgery on HIV-infected patients is not restricted to specialist centres. We review the means of identifying HIV-infected patients, the precautions that can be taken to minimise HIV transmission during surgery, and the possible influences of HIV status on surgical decisions.(ABSTRACT TRUNCATED AT 250 WORDS)

Full text

PDF
281

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brearley S., Buist L. J. Blood splashes: an underestimated hazard to surgeons. BMJ. 1989 Nov 25;299(6711):1315–1315. doi: 10.1136/bmj.299.6711.1315. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Ferguson C. M. Surgical complications of human immunodeficiency virus infection. Am Surg. 1988 Jan;54(1):4–9. [PubMed] [Google Scholar]
  3. Hussain S. A., Latif A. B., Choudhary A. A. Risk to surgeons: a survey of accidental injuries during operations. Br J Surg. 1988 Apr;75(4):314–316. doi: 10.1002/bjs.1800750407. [DOI] [PubMed] [Google Scholar]
  4. Imagawa D. T., Lee M. H., Wolinsky S. M., Sano K., Morales F., Kwok S., Sninsky J. J., Nishanian P. G., Giorgi J., Fahey J. L. Human immunodeficiency virus type 1 infection in homosexual men who remain seronegative for prolonged periods. N Engl J Med. 1989 Jun 1;320(22):1458–1462. doi: 10.1056/NEJM198906013202205. [DOI] [PubMed] [Google Scholar]
  5. Kelen G. D., Fritz S., Qaqish B., Brookmeyer R., Baker J. L., Kline R. L., Cuddy R. M., Goessel T. K., Floccare D., Williams K. A. Unrecognized human immunodeficiency virus infection in emergency department patients. N Engl J Med. 1988 Jun 23;318(25):1645–1650. doi: 10.1056/NEJM198806233182503. [DOI] [PubMed] [Google Scholar]
  6. Lowenfels A. B., Wormser G. P., Jain R. Frequency of puncture injuries in surgeons and estimated risk of HIV infection. Arch Surg. 1989 Nov;124(11):1284–1286. doi: 10.1001/archsurg.1989.01410110038007. [DOI] [PubMed] [Google Scholar]
  7. Matta H., Thompson A. M., Rainey J. B. Does wearing two pairs of gloves protect operating theatre staff from skin contamination? BMJ. 1988 Sep 3;297(6648):597–598. doi: 10.1136/bmj.297.6648.597. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Moss A. R. Epidemiology of AIDS in developed countries. Br Med Bull. 1988 Jan;44(1):56–67. doi: 10.1093/oxfordjournals.bmb.a072246. [DOI] [PubMed] [Google Scholar]
  9. Pinching A. J., Weiss R. A., Miller D. AIDS and HIV infection: new perspectives. Br Med Bull. 1988 Jan;44(1):1–19. doi: 10.1093/oxfordjournals.bmb.a072233. [DOI] [PubMed] [Google Scholar]
  10. Piot P., Caraël M. Epidemiological and sociological aspects of HIV-infection in developing countries. Br Med Bull. 1988 Jan;44(1):68–88. doi: 10.1093/oxfordjournals.bmb.a072247. [DOI] [PubMed] [Google Scholar]
  11. Quinn T. C., Glasser D., Cannon R. O., Matuszak D. L., Dunning R. W., Kline R. L., Campbell C. H., Israel E., Fauci A. S., Hook E. W., 3rd Human immunodeficiency virus infection among patients attending clinics for sexually transmitted diseases. N Engl J Med. 1988 Jan 28;318(4):197–203. doi: 10.1056/NEJM198801283180401. [DOI] [PubMed] [Google Scholar]
  12. Rothenberg R., Woelfel M., Stoneburner R., Milberg J., Parker R., Truman B. Survival with the acquired immunodeficiency syndrome. Experience with 5833 cases in New York City. N Engl J Med. 1987 Nov 19;317(21):1297–1302. doi: 10.1056/NEJM198711193172101. [DOI] [PubMed] [Google Scholar]
  13. Tschachler E., Groh V., Popovic M., Mann D. L., Konrad K., Safai B., Eron L., diMarzo Veronese F., Wolff K., Stingl G. Epidermal Langerhans cells--a target for HTLV-III/LAV infection. J Invest Dermatol. 1987 Feb;88(2):233–237. doi: 10.1111/1523-1747.ep12525402. [DOI] [PubMed] [Google Scholar]

Articles from Annals of The Royal College of Surgeons of England are provided here courtesy of The Royal College of Surgeons of England

RESOURCES