Detection of Visually Imperceptible Blood Contamination in the Surgical Area Using Luminol Among Different Oral Surgical Procedures: An Observational Study

利用鲁米诺检测不同口腔外科手术中手术区域肉眼无法察觉的血液污染:一项观察性研究

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Abstract

Introduction Oral surgeons often encounter a significant occupational risk of exposure to potentially harmful infectious diseases during minor oral surgical procedures. These diseases can be transmitted through direct contact with body fluids and aerosolized splatters that may not be visibly detectable. The likelihood of transmission is heightened for clinicians, healthcare workers, and patients alike. The reported prevalence of exposure to blood-borne infections in this field is as high as 90%, with half of these exposures being visually imperceptible. Aim The aim was to detect visually imperceptible blood contamination on personal protective equipment (PPE) and clinical surfaces using the chemiluminescence agent luminol during oral surgical procedures. Materials and methods Thirty minor oral surgical procedures were performed in the Oral and Maxillofacial Surgery Department after obtaining approval from the Institutional Ethics Committee (IEC), Vinayaka Mission's Sankarachariyar Dental College, Vinayaka Mission's Research Foundation, Salem, India. The surgeon, assistant, patient, and clinical surfaces (comprising 15 subsites within the surgical field) wore PPE. The PPE was scrutinized for traces of visually imperceptible blood contamination using luminol. The results of blood splatter on PPE and clinical surfaces in different oral surgical procedures between the non-aerosol and aerosol groups of different durations were analyzed statistically using the chi-square test with p < 0.05 considered significant. Results We observed that visually imperceptible blood contamination in non-aerosol procedures was detected on the assistant PPE kit (46.7%, n = 14), assistant face shield (40%, n = 12), suction apparatus (50%, n = 15), wall (30%, n = 9), and floor (56.7%, n = 17), in both aerosol and non-aerosol procedures. The p-value has been considered statistically significant at p < 0.05 between both the groups (aerosol and non-aerosol). Conclusion Our study results confirmed the presence of undetected blood spillage during aerosol procedures of 30 minutes and non-aerosol surgical procedures of more than 30 minutes over an area of 3.1 feet horizontally and 4.8 feet vertically. So, we strongly emphasize that PPE kits and face shields are mandatory for both surgeon and assistant while performing oral surgical procedures in order to prevent the risk of cross infections, proper infection prevention control protocol for the clinical surfaces also needs to be followed as a standard protocol in all operations.

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