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Superficial needle stick injury from a cutting suture needle that did n...
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Superficial needle stick injury from a cutting suture needle that did not bleed

Yesterday I accidentally stuck myself with a cutting suture needle while we were performing an operation. I had on gloves and I felt my thumb hurt like it got pricked. There was no evidence of a puncture or blood on my gloves. I keep on squeezing my thumb during the operation and when I removed my gloves there was still no blood. I washed my thumb with soap and running water, then keep on applying alcohol. I keep on looking at my thumb because it hurts but there was no puncture or any evidence of a cut. I have been shocked by the incident and could not function properly since then. I did not report the incident yet. I am a mother of a 2 year old and I'm very worried of how this will affect my work and my family.

My patient is a 55 year old male driver who accidentally got hit a car. He had tattoos all over his body and had previous operations about 18 years ago. There was nothing on the chart with regards to HepB or HIV screening...

I want to my risks if they are high or low.
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Avatar_dr_m_tn
Hello,

In general, the type of exposure that you described is low risk. Some of the important factors about the sharps exposure/needlestick are: volume of bodily fluid exchanged (likely very small amount if you had a small, shallow puncture), gauge of the needle, whether or not the sharp has a hollow bore (suture needles do not), HIV/Hepatitis C/Hepatitis B status of the source patient, whether or not the exposed person was wearing gloves, whether or not the exposed area was immediately cleaned.

I recommend that you consult the CDC guidelines that I have included below to read more about exposures and risk. In general, exposures like the one that you describe are considered low risk. The most important unknown in the situation that you describe is the source patient's status with regard to HIV/Hepatitis C/Hepatitis B. If there is no information in the chart regarding this information, the recommendation is to report the incident (all exposures should be reported) and consult with your employee health services representative to and adhere to your institution's established policy and procedure to investigate the source patient's status. It is very important that this be done immediately after the exposure so that HIV prophylaxis can be started as soon as possible (if indicated).

While I cannot provide medical advice in your specific case, situations similar to the one you describe are generally "low" risk and HIV prophylaxis is not recommended. The finally decision regarding prophylaxis is dependent upon the factors that I have listed above.

Other important preventive measure are: up to date tetanus and hepatitis B immunity (vaccine series of three injections which can be confirmed by titers).

Please follow up with additional questions that you may have.

http://www.cdc.gov/ncidod/dhqp/pdf/bbp/exp_to_blood.pdf

~•~ Dr. Parks

This answer is not intended as and does not substitute for medical or legal advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.
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Philip D Parks, MD, MPH, MOccH, F...Blank
Cambridge Health Alliance, Harvard Medical School
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