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Spit landing on surgical cuts
I apologize if this is ridiculous.
I see a very talented plastic surgeon who removes benign tumors just beneath the layers of my skin. During the in-office procedure, he makes a small incision, removes the mass, and put in a stich or two. His talent is evident by scars that are barely noticeable. The issue is that he likes to hold a conversation while removing the lesions, and he sometimes spits slightly when talking (as most of do from time to time – just that normal amount of slight spittle) . He does not wear a surgical mask. I know saliva cannot transmit HIV in kissing, but there is something worrisome for me about the possibility of a fleck of saliva, especially if he had a cut in his mouth, going straight into my bloodstream via the fresh incision.
It would come across as insulting to ask him to put on a mask, yet I want to be sure that there is no risk in a situation where he is not wearing a mask.
I see a very talented plastic surgeon who removes benign tumors just beneath the layers of my skin. During the in-office procedure, he makes a small incision, removes the mass, and put in a stich or two. His talent is evident by scars that are barely noticeable. The issue is that he likes to hold a conversation while removing the lesions, and he sometimes spits slightly when talking (as most of do from time to time – just that normal amount of slight spittle) . He does not wear a surgical mask. I know saliva cannot transmit HIV in kissing, but there is something worrisome for me about the possibility of a fleck of saliva, especially if he had a cut in his mouth, going straight into my bloodstream via the fresh incision.
It would come across as insulting to ask him to put on a mask, yet I want to be sure that there is no risk in a situation where he is not wearing a mask.
MEDICAL PROFESSIONAL
Welcome back to the forum.
As Teak replied before me (below), saliva is generally believed not to be infectious for HIV. Saliva kills the virus. HIV is never transmitted during surgery, even when the surgeon has HIV -- and from a statistical standpoint, it is probably very unlikely your plastic surgeon has HIV.
That said, I'm a little surprised he didn't use a mask, and it would not be unreasonable to ask him why he does not do so, or to wear one in future operations on you. However, the purpose of masking during surgery is not to protect patients from blood-borne infections like HIV. The intent is to prevent bacterial wound infections (e.g., staph, strep); and to protect the surgeon from the patient's body secretions.
Whether or not you speak with him about use of a mask, you are at absolutely no risk of HIV or other blood-borne infections on account of your surgery.
Best wishes-- HHH, MD
As Teak replied before me (below), saliva is generally believed not to be infectious for HIV. Saliva kills the virus. HIV is never transmitted during surgery, even when the surgeon has HIV -- and from a statistical standpoint, it is probably very unlikely your plastic surgeon has HIV.
That said, I'm a little surprised he didn't use a mask, and it would not be unreasonable to ask him why he does not do so, or to wear one in future operations on you. However, the purpose of masking during surgery is not to protect patients from blood-borne infections like HIV. The intent is to prevent bacterial wound infections (e.g., staph, strep); and to protect the surgeon from the patient's body secretions.
Whether or not you speak with him about use of a mask, you are at absolutely no risk of HIV or other blood-borne infections on account of your surgery.
Best wishes-- HHH, MD
MEDICAL PROFESSIONAL
My understanding of the Oklahoma dentist is that he has HIV and hepatitis C, and that he (and/or his office staff) used substandard infection control procedures. I have not heard that any of his patients has actually been found to be infected. News reports are that up to 7,000 people may be tested. My bet is that none of them will be found to have been infected.
The first (heretofore only) case of HIV transmisison in a dental office is suspected to have resulted from intentional injection of patients with the dentist's infected blood. The dentist died of AIDS before an investigation could be completed and it was dropped without legal resolution. This situation is obviously irrelvant to risks from routine dental care.
And what if there really were an exceedingly rare occurrence of such transmission? It would not elevate your risk. Getting killed by lightning or meteorites are rare events, but they happen. When they do, it doesn't make your risk any higher than the near-zero level it was anyway.
For those reasons, I would advise you to drop this line of worry or questioning. It's a pointless exercise in futility.
The first (heretofore only) case of HIV transmisison in a dental office is suspected to have resulted from intentional injection of patients with the dentist's infected blood. The dentist died of AIDS before an investigation could be completed and it was dropped without legal resolution. This situation is obviously irrelvant to risks from routine dental care.
And what if there really were an exceedingly rare occurrence of such transmission? It would not elevate your risk. Getting killed by lightning or meteorites are rare events, but they happen. When they do, it doesn't make your risk any higher than the near-zero level it was anyway.
For those reasons, I would advise you to drop this line of worry or questioning. It's a pointless exercise in futility.
Thanks, Doctor. I've actually seen three doctors over the years for these in-office surgical procedures and none has masked. Since transmission is not possible, I won't worry about it.
This would be a different thread topic, but I was deeply disturbed to hear about HIV transmission from the dentist in Oklahoma. Apparently this is the only the second case of transmission in a dental office, but that's two too many. The reports I have read have implicated improperly sanitized equipment. Even transmission via that route surprised me, however. While dipping dental instruments in bleach is not recommended, I thought the virus dies quickly outside of the body and that the only real risk of transmission would be from re-used injection needles (which may have also been in the office). It's a terrible case and deeply disturbing that HIV transmission has occurred in a medical setting.
This would be a different thread topic, but I was deeply disturbed to hear about HIV transmission from the dentist in Oklahoma. Apparently this is the only the second case of transmission in a dental office, but that's two too many. The reports I have read have implicated improperly sanitized equipment. Even transmission via that route surprised me, however. While dipping dental instruments in bleach is not recommended, I thought the virus dies quickly outside of the body and that the only real risk of transmission would be from re-used injection needles (which may have also been in the office). It's a terrible case and deeply disturbing that HIV transmission has occurred in a medical setting.
Saliva is not infectious.
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