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ARTICLE |

Routine Preoperative Screening for HIV FREE

Joseph S. Carey, MD
[+] Author Affiliations

Edited by Jody W. Zylke, MD, Contributing Editor; Sharon Iverson, Assistant editor.


JAMA. 1988;260(2):179-179. doi:10.1001/jama.1988.03410020039012
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To the Editor.—  I wish to take issue with the SPECIAL COMMUNICATION entitled "Routine Preoperative Screening for HIV: Does the Risk to the Surgeon Outweigh the Risk to the Patient?"1 The authors, three nonsurgeons, make a number of assumptions, such as a "first-order approximation" of the rate of skin penetration from intraoperative injuries to the surgeon's hands of 2%. The reverse calculation of skin-puncture rate from seroconversion to hepatitis B virus among surgeons is farfetched and not particularly pertinent. More pertinent would be an attempt to estimate the highest possible risk. Such data are critical to those of us who are exposed.The skin-puncture rate could be assumed to be equal to the glove-puncture rate, since multiple punctures may occur during the same procedure and frequent glove changes are common. If the glove-puncture rate is 25% and the risk of human immunodeficiency virus (HIV) infection after skin puncture is

REFERENCES

Hagen MD, Meyer KB, Pauker SG:  Routine preoperative screening for HIV: Does the risk to the surgeon outweigh the risk to the patient? JAMA 1988;;259:1357-1359.
Friedland GH, Klein RS:  Transmission of the human immunodeficiency virus . N Engl J Med 1987;;317:1125-1135.
McCray E:  Occupational risk of the acquired immune deficiency syndrome among health care workers . N Engl J Med 1986;;314:1127-1132.
Henry K, Brown RJ, Polesky HF, et al:  Non-donor HIV antibody testing in Minnesota . N Engl J Med 1986;;315:581-582.
Zuck TF:  Transfusion-transmitted AIDS reassessed . N Engl J Med 1988;;318:511-512.
Curran JW, Jaffe HW, Hardy AM, et al:  Epidemiology of HIV infection and AIDS in the United States . Science 1988;;239:610-616.

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Hagen MD, Meyer KB, Pauker SG:  Routine preoperative screening for HIV: Does the risk to the surgeon outweigh the risk to the patient? JAMA 1988;;259:1357-1359.
Friedland GH, Klein RS:  Transmission of the human immunodeficiency virus . N Engl J Med 1987;;317:1125-1135.
McCray E:  Occupational risk of the acquired immune deficiency syndrome among health care workers . N Engl J Med 1986;;314:1127-1132.
Henry K, Brown RJ, Polesky HF, et al:  Non-donor HIV antibody testing in Minnesota . N Engl J Med 1986;;315:581-582.
Zuck TF:  Transfusion-transmitted AIDS reassessed . N Engl J Med 1988;;318:511-512.
Curran JW, Jaffe HW, Hardy AM, et al:  Epidemiology of HIV infection and AIDS in the United States . Science 1988;;239:610-616.
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