Barriers to the reporting and management of needlestick injuries among surgeons.

OBJECTIVE: Needlestick injuries are common within surgical practice and carry the risk of transmission of blood borne viruses. Key to reducing this risk is an accessible system of reporting and involvement of occupational health services. We aimed to identify surgeons' attitude and experience dealing with such injuries and identify why in many cases needlestick injuries go unreported. METHODS: 70 questionnaires were hand delivered to surgeons and trainees across 3 UK hospitals and a variety of surgical specialties. The number of injuries and reporting practice was identified. Surgeons were asked to identify from a list the reasons why they did not report their injuries and record importance on a 5-point scale (0-4). RESULTS: 52 surgeons and trainees replied (75%). 42 (81%) had suffered at least 1 needlestick injury with 4 (8%) reporting more than 20. 8 (19%) had reported all their injuries to occupational health with no significant difference in reporting between consultants and trainees (P = 0.2). 12 (23%) felt that reporting of injuries helped to reduce transmission rates. 18 (35%) said that a needlestick had caused them moderate or significant anxiety. The top reasons for not reporting were (0-4). (1) Process too time consuming (2.7), (2) transmission risk very low (2.6), (3) do not want to disrupt operating list (2.0), (4) post exposure prophylaxis ineffective (1.3). CONCLUSIONS: Most surgeons and trainees do not report all their needlestick injuries to occupational health despite many reporting injury related anxiety. The process is felt to take too long and the perceived risk of viral transmission is low.

Sea urchin spine injuries of the hand.

Sea urchin spine injuries are common. They usually cause local pain and swelling that subsides. Chronic granulation is rare. We report two cases of sea urchin granulomata involving finger metacarpophalangeal joints. Both resolved following surgery.