Risk of blood splashes in otorhinolaryngology surgery: do we really require protection?


  • Bikash Lal Shrestha Department of ENT-HNS, Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal
  • Ram Chayya Man Amatya Department of ENT-HNS, Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Nepal




Blood splashes, Glass, Gown, Mask, Surgery


Background: Surgeons are particularly at risk from blood borne pathogens like hepatitis and HIV during interventions or surgeries. They do take precaution to avoid the needle stick injuries but few pay attention on blood or body fluid splashes into eye. The main aim of the study was to know the risk of blood splashes in glass, gown and mask during ENT –HNS (ear, nose and throat and head and neck surgery).

Methods: The prospective study conducted in Department of ENT-HNS of Dhulikhel Hospital, Kathmandu University Hospital from 1st July 2016 to 30th September 2016. All the elective cases were included for study. Surgery was performed by the single surgeon. The surgeon wore the glass and mask during the surgery. At the end of the surgery, the glass, mask and gown was inspected by the surgeon for any blood splashes and information was recorded.  

Results: There were total 62 patients with male 30 and female 32. Regarding the age, most of the patients lie between 20-50 years. The amount of blood splatter in glass, mask and gown is most common in modified radical mastoidectomy surgery. Likewise, the blood splatter is most common in tonsillectomy in throat surgery and in head and neck surgery, the blood splatter is common in all head and neck surgery.

Conclusions: The blood splashes is high even in various ENT surgeries. So it is important to take precaution by surgeon like protective mask and glass worn during surgeries to protect from various blood-borne infection transmissions. 


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Halota W, Pawlowska M. HCV infections in view of clinical practice. Med Sci Monit. 2004;10(1):24–8.

Simonsen L, Kane A, Lloyd J, Zaffran M, Kane M. Unsafe infections in developing world and transmission of bloodborne pathogens: a review. Bull World Health Organ.1999;77:789–800.

Kane A, Lloyd J, Zaffran M, Simonsen L, Kane M. Transmission of hepatitis B, hepatitis C and human immunodefi ciency viruses through unsafe injections in the developing world: model-based regional estimates. Bull World Health Organ. 1999;77:801–7.

Clark PA, O’Brien K. Fighting AIDS in Sub-Saharan Africa: Is a public-private partnership a viable paradigm? Med Sci Monit. 2003;9(9):28–39.

Fitch KM, Alvarez LP, Medina RDA, Morrondo RN. Occupational transmission of HIV in health care workers. A review. European J Public Health. 1995;5:175–86.

Mitsui T, Iwano K, Masuko K, Yamazaki C, Okamoto H, Tsuda F, et al. Hepatitis C virus infection in medical personnel after needle stick accident. Hepatology. 1992;16:1109–14.

Sartori M, La Terra G, Aglietta M, Manzin A, Navino C, Verzetti G. Transmission of hepatitis C via blood splash into conjunctiva. Scand J Infect Dis. 1993;25:270–1.

Center for Disease Control: Recommendations for protection against viral hepatitis. Morb Mortal Wkly Rep. 1985;34(22):313-24.

Wnuk AM. Occupational exposure to HIV infection in health care workers. Med Sci Monit. 2003;9(5):249–52.

Bell DM. Human immunodeficiency virus transmission in health care settings: risk and risk reduction. Am J Med. 1991;91(3):294–300.

Centers for Disease Control: Update: human immunodeficiency virus infections in health-care workers exposed to blood of infected patients. Morb Mortal Wkly Rep. 1987;36:285–9.

Centers for Disease Control and Prevention: Human immunodeficiency virus transmission in household settings-United States. MMWR.1994;43:347,353–6.

Saltzman DJ, Williams RA, Gelfand DV, Wilson SE. The surgeon and AIDS: twenty years later. Arch Surg. 2005;140:961–7.

News. Italian nurse in AIDS compensation test case. Nurs Stand. 1995;9(46):12.

AVSC International: Infection prevention curriculum: A training course for healthcare providers and other staff of hospital and clinics. Trainer’s manual & Participant’s handbook. AVSC, USA; 1999.

Brearley S, Buist LJ. Blood splashes: an underestimated hazard to surgeons. BMJ. 1989;299:1315.

Marasco S, Woods S. The risk of eye splash injuries in surgery. Aust NZ J Surg. 1998;68:785–7.

Berridge DC, Lees TA, Chamberlain J, Jones NAG. Eye protection for the vascular surgeon. Br J Surg. 1993;80:1379–80.

Lakhani R, Loh Y, Zhang TT, Kothari P.A prospective study of blood splatter in ENT. Eur Arch Otorhinolaryngol. 2015;272:1809-12.

Bell KM, Clement DA. Eye protection for the surgeon. J R Coll Surg Edinb. 1992;37:60–1.






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