Sharps injuries: the risks and relevance to plastic surgeons

Occupational hazards and pregnancy in orthopaedics: female surgeons are at increased risk of infertility and pregnancy complications

Female surgeons have increased rates of infertility and pregnancy complications compared to the general population. Reported infertility rates in surgeons are 32% compared to 10.9% in the general population. Reported pregnancy complication rates in surgeons range from 25% to 35%. In the orthopaedic operating theatre occupational hazards that have an effect on pregnancy outcomes include radiation, exposure to methyl methacrylate in bone cement, surgical smoke, sharps injuries, exposure to anaesthetic waste gases and the effects of the physical demands of surgery including prolonged work hours and night shift work. Outside the operating theatre exposure to nitrous oxide, formaldehyde, surgical scrub also have evidence of negative pregnancy outcomes. This review summarizes the available evidence as it relates to specific occupational hazards that face health workers in an orthopaedic operating theatre. This information, while targeted at orthopaedic health workers, is also relevant to anaesthetists, radiographers, nursing staff, medical device company representatives and female surgeons in other specialties.

Office-based Plastic Surgery-Evidence-based Clinical and Administrative Guidelines

Outpatient procedures are extremely prevalent in plastic surgery, with an estimated 82% of cosmetic plastic surgery occurring in this setting. Given that patient safety is paramount, this practical review summarizes major contemporary, evidence-based recommendations regarding office-based plastic surgery. These recommendations not only outline clinical aspects of patient safety guidelines, but administrative, as well, which in combination will provide the reader/practice with a structure and culture that is conducive to the commitment to patient safety. Proper protocols to address potential issues and emergencies that can arise in office-based surgery, and staff familiarity with thereof, are also necessary to be best prepared for such situations.

Occupational risks to pregnant obstetrics and gynaecology trainees and physicians: Is it time to think about this?

The proportion of women in the workforce has been steadily increasing worldwide. Women now constitute approximately 75% of the global health workforce and almost 90% in nursing and midwifery professions. The present times have witnessed a dramatic gender shift in the speciality of obstetrics and gynaecology. Women now comprise a significant proportion of practicing obstetrics and gynaecology specialists all over the world. In 2018, more than 80% of resident doctors and nearly 60% of physicians in the speciality were female, far exceeding any other surgical speciality. Most resident doctors and a significant proportion of practising physicians in obstetrics and gynaecology are in the reproductive age group. They will become pregnant at some point in their training program or career. The present review focuses on all work-related exposure risks for pregnant obstetrics and gynaecology professionals. It discusses the risks of infectious diseases, radiation, stress, violence against doctors, and even peer support (or lack of it) that can have deleterious effects on the health of pregnant physicians and the health of their unborn foetuses.

A Roadmap for Navigating Occupational Exposures for Surgeons: A Special Consideration for the Pregnant Surgeon

SUMMARY

Surgeons are exposed to occupational hazards daily. Risks include chemical, biological, and physical hazards that place providers at risk of serious harm. Departmental policies or written guides to help pregnant surgeons navigate the hospital are lacking. In response to the scarcity in the literature, the authors have summarized current guidelines and recommendations to aid surgeons in making an informed decision. In addition, the authors present a brief narrative of the impact of these exposures during pregnancy and methods of transmission and, where relevant, include specialties that are at risk of these exposures.

Surgical applications of intracorporal tissue adhesive agents: current evidence and future development

Introduction: Traditional mechanical closure techniques pose many challenges including the risk of infection, tissue reaction, and injury to both patients and clinicians. There is an urgent need to develop tissue adhesive agents to reform closure technique. This review examined a variety of tissue adhesive agents available in the market in an attempt to gain a better understanding of intracorporal tissue adhesive agents as medical devices.Areas covered: Fundamental principles and clinical determinants of the tissue adhesives were summarized. The available tissue adhesives for intracorporal use and their relevant clinical evidence were then presented. Lastly, the perspective of future development for intracorporal tissue adhesive were discussed. Clinical evidence shows current agents are efficacious as adjunctive measures to mechanical closure and these agents have been trialed outside of clinical indications with varied results.Expert opinion: Despite some advancements in the development of tissue adhesives, there is still a demand to develop novel technologies in order to address unmet clinical needs, including low tensile strength in wet conditions, non-controllable polimerization and sub-optimal biocompatibility. Research trends focus on producing novel adhesive agents to remit these challenges. Examples include the development of biomimetic adhesives, externally activated adhesives, and multiple crosslinking strategies. Economic feasibility and biosafety are limiting factors for clinical implementation.

Healthcare Waste Management: A Case Study from Sudan

Healthcare waste (HCW) represents a major public health issue, especially in developing countries. Among HCW categories, sharps waste is one of the most hazardous. Exposure to needle-stick injuries can lead to blood-borne pathogens, therefore HCW should be managed in an effective manner. The main aims of this study were to assess the current management of used needles and to suggest suitable recommendations for an improved and safer system for needle management in Khartoum, Sudan. The study showed that the management of both healthcare and home-generated HCW in Sudan is inefficient, as all wastes are mixed together and disposed of improperly, especially used needles. The study attributes this to many reasons, including lack of waste segregation at the source, lack of policies, failure of planning, inadequate training, lack of awareness of the hazardous nature of such kinds of waste, weak infrastructure, and a lack of suitable treatment technologies. The estimated average generated rate of HCW ranged from 0.38 to 0.87 kg/bed/day in 2009 and 2012, respectively. Such ineffective healthcare waste management HCWM, especially used needles, can put public health as well as the environment at risk, particularly waste workers, thus urgent action needs to be taken by all involved parties and at all levels.