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Needlestick Injuries in Surgical Residents

Nearly all surgical residents experience needlestick injuries during training; more than half of such injuries go unreported.

During the last decade, healthcare institutions have attempted to decrease the risk for exposure to blood-borne pathogens by expanding education and introducing safer "sharp" medical devices. How common are needlestick injuries now among surgeons in training, for whom risk has been greatest? When do the injuries occur, and why are they not reported? To find out, researchers asked 741 surgical trainees at 17 U.S. residency programs to complete an anonymous survey regarding previous needlestick injuries.

Of 699 respondents, 582 (83%) had experienced at least 1 needlestick injury, with a mean of 3.8 injuries per resident. The prevalence of exposure increased by year of training; by the fifth postgraduate year, 99% of the trainees had had a needlestick injury. In further analysis of the most recent event, most injuries had occurred in the operating room with solid-bore needles, and most were accidentally self-inflicted when the trainee was feeling "rushed." Fifty-one percent of the respondents had not reported their most recent injury. Factors significantly associated with not reporting an injury included male sex, lack of involvement of a high-risk patient, occurrence in the operating room, and lack of knowledge of the injury by another person.

Comment: These findings may provide some reassurance to surgical trainees being counseled following operating-room needlestick injuries, given the high rate of such exposures among previous trainees and the relative rarity of reported HIV and hepatitis C infections stemming from those events. Still, the consequences of even a single infection with a blood-borne pathogen can be devastating, and we need to increase our efforts both to prevent such injuries and to ensure appropriate medical management for people who experience them.

— Richard T. Ellison III, MD

Published in Journal Watch Infectious Diseases July 3, 2007

Citation(s):

Makary MA et al. Needlestick injuries among surgeons in training. N Engl J Med 2007 Jun 28; 356:2693-9.

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