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New safety skin hooks
New safety skin hooks JASMINE G. BROOKS, DO,and MICHAEL R. ABIDIN, MD, Alexandria, Virginia, and Streetsboro, Ohio
The recent AIDS epidemic has focused considerable energy on the design of safer medical equipment. In fact, the number of health care workers dying of AIDS is only a small percentage those dying of blood-borne diseases.~ Hepatitis B and C are responsible for approximately 300 deaths each year according to Centers for Disease Control and Prevention (CDC) statistics. 2 The number of health care workers di,~abled each year has been reported to be much greater, although it is difficult to determine the exact number. The issue of exposure to blood has been quantitated by EPINet, an incident documentation system operated by the University of Virginia Medical Center. 3,4 Current estimates project that only a small percentage of the total reported injuries result from skin hooks; however, the low perceived risk of blood-borne transmission associated with this type of injury may play a role in underreporting. 5 The financial costs associated with injuries from sharp instruments is difficult to estimate but would include lost 'wages, cost of health care, and cost of disability. The base cost of each sharp-instrument injury for a group of South Florida hospitals has been estimated at $800. 6 The number of needlestick and sharpinstrument injuries occurring annually nationwide is approximately 800,000. 7 The cost of adopting this type of technology is offset by the reduction in costs for exposures. DESCRIPTION OF DEVICE
The safety skin hook has a retractible guard that moves in a longitudinal direction along the long axis of the instrument (Fig. 1). In the retracted position the safety hook functions as a standard hook. The guard is advanced with one hand during use and passing to help to prevent inadvertent contact with the hooks.
Dr. Brooks is in private practice in Cleveland, Ohio, and Dr. Abidin is in privatepracticein Alexandria, Virgina. Reprint requests: Michael R. Abidin, MD, 5808 Appleford Dr., Alexandria, VA 22310. Otolaryngol Head Neck Surg 1997;117:135-6. Copyright © 1997 by the American Academy of OtolaryngologyHead and Neck SurgeryFoundation, Inc. 0194-5998/97/$5.00 + 0 23/75180230
Fig. 1. Highly schematic drawings of the safety skin hook in its guarded and unguarded positions.
The device may also be left in place as a retractor after the flap is clamped and does not require constant monitoring as does a regular hook. CONCLUSIONS
The problems associated with blood-borne disease relative to sharp instruments have not received an appropriate amount of attention. Whereas the acceptance of and spending for protective apparel as part of universal precautions has greatly increased in recent years. There has not been a commensurate increase in spending for systems to prevent sharp-instrument injuries, which pose far greater risk. 8 Documentation systems such as EPINet help to identify the causes of exposures to blood despite the fact that the rates of underreporting are estimated to be 40% to 90%. 8 The annual incidence of hepatitis B virus seroconversion for all causes is approximately 18,000. 7 The economic losses and personal suffering are staggering. The current literature describes guidelines for new safety technology that include and encourage ease of use, passive activation, new technologies, and rigorous evaluation of existing technologies. 7-9 Given the number of health care workers disabled and dying of blood-borne diseases, we must encourage all efforts to limit percutaneous exposure to blood.
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136 BROOKSand ABIDIN
REFERENCES 1. Bell DM. Human immunodeficiency virus transmission in health care settings: risk and risk reduction. Am J Med 1991;91(suppl 3B):294-300. 2. Information please almanac, 48th ed. New York: HoughtonMifflin, 1995:858. 3. Jagger J, Cohen M, Blackwell B. EPINet: a tool for surveillance and prevention of blood exposures in health care settings. Essentials of modern hospital safety 1994. Ann Arbor: Lewis Publishers, 1994:223-39. 4. Jagger J, Detmer DE, Blackwell B, et al. Percutaneous injuries among operating room personnel. Conference on Preventing Bloodborne Pathogen Transmission in Surgery and Obstetrics. Atlanta, Ga.: Feb 14, 1984.
OtolaryngologyHead and Neck Surgery JuJy 1997
5. Short L J, Bell DM. Risk of occupational infection with bloodborne pathogens in operating and delivery room settings. Am J Infect Control 1993;21:343-50. 6. Gomez M, Narushko J, Advances in exposure prevention interview. Advances in Exposure Prevention 1995;1:5-10. 7. APIC position paper. Prevention of device mediated blood-borne infections to health care workers. Am J Infect Control 1993;21:76-8. 8. McCormick RD, Meisch MG, Ircink FG, et al. Epidemiology of hospital sharps injuries: a 14-year prospective study in the preAIDS and AIDS eras. Am J Med 1991;91(suppl 3B):301-7. 9. Tokars JI, Bell DM, Culver DH, et al. Percutaneous injuries during surgical procedures. JAMA 1992;267:2899-904.
The recent AIDS epidemic has focused considerable energy on the design of safer medical equipment. In fact, the number of health care workers dying of AIDS is only a small percentage those dying of blood-borne diseases.~ Hepatitis B and C are responsible for approximately 300 deaths each year according to Centers for Disease Control and Prevention (CDC) statistics. 2 The number of health care workers di,~abled each year has been reported to be much greater, although it is difficult to determine the exact number. The issue of exposure to blood has been quantitated by EPINet, an incident documentation system operated by the University of Virginia Medical Center. 3,4 Current estimates project that only a small percentage of the total reported injuries result from skin hooks; however, the low perceived risk of blood-borne transmission associated with this type of injury may play a role in underreporting. 5 The financial costs associated with injuries from sharp instruments is difficult to estimate but would include lost 'wages, cost of health care, and cost of disability. The base cost of each sharp-instrument injury for a group of South Florida hospitals has been estimated at $800. 6 The number of needlestick and sharpinstrument injuries occurring annually nationwide is approximately 800,000. 7 The cost of adopting this type of technology is offset by the reduction in costs for exposures. DESCRIPTION OF DEVICE
The safety skin hook has a retractible guard that moves in a longitudinal direction along the long axis of the instrument (Fig. 1). In the retracted position the safety hook functions as a standard hook. The guard is advanced with one hand during use and passing to help to prevent inadvertent contact with the hooks.
Dr. Brooks is in private practice in Cleveland, Ohio, and Dr. Abidin is in privatepracticein Alexandria, Virgina. Reprint requests: Michael R. Abidin, MD, 5808 Appleford Dr., Alexandria, VA 22310. Otolaryngol Head Neck Surg 1997;117:135-6. Copyright © 1997 by the American Academy of OtolaryngologyHead and Neck SurgeryFoundation, Inc. 0194-5998/97/$5.00 + 0 23/75180230
Fig. 1. Highly schematic drawings of the safety skin hook in its guarded and unguarded positions.
The device may also be left in place as a retractor after the flap is clamped and does not require constant monitoring as does a regular hook. CONCLUSIONS
The problems associated with blood-borne disease relative to sharp instruments have not received an appropriate amount of attention. Whereas the acceptance of and spending for protective apparel as part of universal precautions has greatly increased in recent years. There has not been a commensurate increase in spending for systems to prevent sharp-instrument injuries, which pose far greater risk. 8 Documentation systems such as EPINet help to identify the causes of exposures to blood despite the fact that the rates of underreporting are estimated to be 40% to 90%. 8 The annual incidence of hepatitis B virus seroconversion for all causes is approximately 18,000. 7 The economic losses and personal suffering are staggering. The current literature describes guidelines for new safety technology that include and encourage ease of use, passive activation, new technologies, and rigorous evaluation of existing technologies. 7-9 Given the number of health care workers disabled and dying of blood-borne diseases, we must encourage all efforts to limit percutaneous exposure to blood.
135
136 BROOKSand ABIDIN
REFERENCES 1. Bell DM. Human immunodeficiency virus transmission in health care settings: risk and risk reduction. Am J Med 1991;91(suppl 3B):294-300. 2. Information please almanac, 48th ed. New York: HoughtonMifflin, 1995:858. 3. Jagger J, Cohen M, Blackwell B. EPINet: a tool for surveillance and prevention of blood exposures in health care settings. Essentials of modern hospital safety 1994. Ann Arbor: Lewis Publishers, 1994:223-39. 4. Jagger J, Detmer DE, Blackwell B, et al. Percutaneous injuries among operating room personnel. Conference on Preventing Bloodborne Pathogen Transmission in Surgery and Obstetrics. Atlanta, Ga.: Feb 14, 1984.
OtolaryngologyHead and Neck Surgery JuJy 1997
5. Short L J, Bell DM. Risk of occupational infection with bloodborne pathogens in operating and delivery room settings. Am J Infect Control 1993;21:343-50. 6. Gomez M, Narushko J, Advances in exposure prevention interview. Advances in Exposure Prevention 1995;1:5-10. 7. APIC position paper. Prevention of device mediated blood-borne infections to health care workers. Am J Infect Control 1993;21:76-8. 8. McCormick RD, Meisch MG, Ircink FG, et al. Epidemiology of hospital sharps injuries: a 14-year prospective study in the preAIDS and AIDS eras. Am J Med 1991;91(suppl 3B):301-7. 9. Tokars JI, Bell DM, Culver DH, et al. Percutaneous injuries during surgical procedures. JAMA 1992;267:2899-904.