From the Guidelines
The risk of contracting HIV from a suture needle stick injury in the operating room is very low, estimated at approximately 0.3% (1 in 300) per exposure. This risk is significantly lower than that associated with hollow-bore needles because suture needles contain less blood volume and typically involve a solid rather than hollow shaft. If such an exposure occurs, immediate action is recommended:
- wash the wound with soap and water,
- report the incident to occupational health, and
- seek post-exposure prophylaxis (PEP) ideally within 2 hours but no later than 72 hours after exposure. Standard PEP typically consists of a 28-day course of antiretroviral medications such as Truvada (tenofovir/emtricitabine) plus either dolutegravir or raltegravir 1. The source patient should be tested for HIV if status is unknown. Risk factors that increase transmission probability include
- deep injury,
- visible blood on the device,
- procedures involving needles placed in arteries or veins, and
- source patients with high viral loads 1. Healthcare workers should always follow universal precautions including
- double-gloving during surgical procedures,
- proper sharps handling, and
- avoiding recapping needles to minimize risk of exposure 1.
From the Research
Risk of HIV Transmission from Suture Needle in OR
- The risk of HIV transmission from a suture needle in the operating room (OR) is a concern for healthcare workers, particularly surgeons and nurses [(2,3,4,5,6)].
- According to a study published in the International Journal of STD & AIDS, the mean risk of HIV transmission after a percutaneous exposure is approximately 0.3% 4.
- The risk of transmission is influenced by several factors, including the viral load of the source patient, the type of procedure being performed, and the use of safety protocols [(2,3,4)].
- A study published in Der Unfallchirurg found that no virus transmissions from needlestick injuries (NSI) were found during the observation period, and that adequate management and follow-up of NSI can achieve low transmission rates 3.
- The Centers for Disease Control and Prevention (CDC) recommends postexposure prophylaxis (PEP) for healthcare workers who experience a needlestick injury, which can reduce the risk of HIV transmission [(2,5)].
Factors Influencing HIV Transmission Risk
- The viral load of the source patient is a significant factor in determining the risk of HIV transmission 4.
- The type of procedure being performed can also influence the risk of transmission, with certain procedures such as cardiothoracic and orthopaedic surgery considered high-risk 4.
- The use of safety protocols, such as proper disposal of needles and the use of personal protective equipment, can reduce the risk of transmission [(2,3)].
- The timely administration of PEP can also reduce the risk of transmission [(2,5)].
Prevention and Management of Needlestick Injuries
- Prevention of needlestick injuries is crucial in reducing the risk of HIV transmission [(2,3)].
- Proper training and education of healthcare workers on safety protocols and the use of personal protective equipment can reduce the risk of needlestick injuries [(2,3)].
- Timely management and follow-up of needlestick injuries, including the administration of PEP, can reduce the risk of transmission [(2,3,5)].
- Regular monitoring and testing of healthcare workers who experience a needlestick injury can also help to reduce the risk of transmission [(3,5)].