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Stacey AW, Czyz CN, Kondapalli SS et al.

University of Michigan, Ann Arbor, MI, USA.

 Ophthal Plast Reconstr Surg 2015;31:182–6.

Richard Scawn’s review: The aim of this study was to highlight an under-appreciated risk to surgeons: blood splatter during oculoplastic surgery. Transmission of human immunodeficiency virus and hepatitis C via inadvertent conjunctival exposure in healthcare workers has unfortunately been established. In this study, the authors examined the protective eye shields of surgeons and assistants for evidence of blood splatter following surgery. The eye shields were allowed to dry and then sprayed with luminol, a chemiluminescent agent used in forensics. The number of luminescent spots on each shield were then counted by two masked reviewers. Controls consisted of eye shields worn in an office setting and by operating room observers.

A total of 331 shields from 131 surgical cases were evaluated, with 203 (61%) shields showing signs of blood splatter. The average number of blood splatters on each shield was 4.4 for primary surgeons and 3.7 for assistants. There were significant statistical differences in blood splatter rate between surgeons (range 29–90%) and between procedure types, with full-thickness eyelid and orbit procedures carrying the highest risk. At the end of the procedure, participants were asked whether they were aware of any blood splatter and the results found that 98% of blood splatters went undetected. This is a thought-provoking study for anyone undertaking oculoplastic surgery, especially those who had not previously considered intraoperative eye protection.

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