Current practice in the management of high-risk orthopaedic trauma patients in Scotland

Surgeons are exposed to bodily fluids on a daily basis with the inherent risk of contracting a blood-borne pathogen. This is especially so in orthopaedic trauma due to prolonged contact with open wounds, manipulation of sharp instruments and bone spikes, frequency of high-risk patients and the possibility of aerosolised virus particles. We aimed to identify what preventative measures orthopaedic trauma theatres in Scotland use to reduce potential transmission of blood-borne pathogens from patients to staff, routinely and in the case of high-risk patients (e.g. hepatitis B + C patients). The 25 orthopaedic trauma units in Scotland were surveyed by telephone questionnaire on their precautions to prevent transmission of blood-born pathogens during exposure prone procedures. All 25 units participated in the study. All units utilised the double gloving technique with one unit using protective under gloves. Only one unit wore enclosure suits on identifying high-risk patients. In only 10 units was eye protection (goggles/visors) mandatory. Simple and effective precautions were taken in all 25 units surveyed to reduce the risk of patient-to-surgeon transmission of blood-borne pathogens. However, facial protection from aerosolised particles was not routine practice in the majority of units.