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Journal of Long-Term Effects of Medical Implants

ISSN for PRINT: 1050-6934

Institutional price:	$1021.00
Issues per year:	6

Best Paper Award Selection - Editorial Board Site

2003, Volume13

72 pages

DOI: 10.1615/JLongTermEffMedImplants.v13.i2

Issue price - $175.00

Recommendations for Postexposure Prophylaxis of Operating Room Personnel and Patients Exposed to Bloodborne Diseases

Richard F. Edlich
Distinguished Professor of Plastic Surgery, Director of Trauma Prevention, Education, and Research, Trauma Specialists, LLP, Legacy Emanuel Hospital; 22500 NE 128th Circle, Brush Prairie WA 98606, USA; Phone: 360-944-7641, Fax: 360-944-7612

Tyler C. Wind, BA
Plastic Surgical Research Program, University of Virginia Health System, Charlottesville, Virginia

Cynthia L. Heather, BS
Plastic Surgical Research Program, University of Virginia Health System, Charlottesville, Virginia

Gregory G. Degnan, MD
Department of Orthopedic Surgery, University of Virginia Health System, Charlottesville, Virginia

David B. Drake, MD
Associate Professor of Plastic Surgery & Orthopedic Surgery. University of Virginia Health System PO Box 800376 Charlottesville VA 22908-0376, USA

ABSTRACT

The purpose of this collective review is to discuss management of operating room personnel who have had occupational exposure to blood and other body fluids that might contain hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and human T-cell lymphotropic virus type I (HTLV-I). HBV postexposure prophylaxis includes starting hepatitis B vaccine series in any susceptible unvaccinated operating room personnel who sustain an exposure to blood or body fluid during surgery. Postexposure prophylaxis with hepatitis B immune globulin (HBIG) is an important consideration after determining the hepatitis B antigen status of the patient. Ideally, all operating room personnel should be vaccinated with hepatitis B vaccine before they pursue their career in surgery. Immune globulin and antiviral agents (e.g., interferon with or without ribavirin) should not be used for postexposure prophylaxis of operating room personnel exposed to patients with HCV; rather, follow-up HCV testing should be initiated to determine if infection develops. Postexposure prophylaxis for HIV involves a basic four-week regimen of two drugs (zidovudine and lamivudine; lamivudine and stavudine; or didanosine and stavudine) for most exposures. An expanded regimen that includes a third drug must be considered for HIV exposures that pose an increased risk for transmission. When developing a postexposure prophylaxis regimen, it is helpful to contact the National Clinicians' Postexposure Prophylaxis Hotline (1-888-448-4911).