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Facial splash without protection common among dermatology residents

A large percentage of surveyed dermatology residents reported facial splash by blood or other potentially infectious material during a procedure while not wearing facial protection, according to research published in Dermatologic Surgery.

“Although dermatology is a procedure-heavy field, there are little data on facial splash and protective practices,” Dorota Z. Korta, MD, PhD, of the dermatology department, UC Irvine Medical Center, Irvine, California, and colleagues wrote.

The researchers sent an anonymous online survey on Feb. 15, 2016, to program directors at 108 U.S. Accreditation Council for Graduation Medical Education (ACGME)-approved dermatology residence programs. To ensure no overlap of data with incoming dermatology residents, the survey deadline was June 1, 2016.

Frequency of facial protection during dermatologic procedures, personal history of splash injury, and reasons for not always wearing facial protection, if applicable, were measured with the survey.

There were 153 dermatology residents who responded to the survey, with all years of training represented.

More than half of the respondents reported facial splashes while not wearing facial protection during local anesthetic injections (53.6%) or during intralesional injections (54.9%). In addition, about one-third reported facial splashes while not wearing facial protection during surgery (32%) and during incision and drainage (32.9%). Among the respondents, 88.9% correctly answered that there was a small risk of acquiring HIV and hepatitis C during mucosal splash. Reasons for not always wearing facial protection during procedures included that it was time consuming (44.4%), limited visibility (55.6%), the belief that the overall risk of infection disease transmission is low (34.6%) or that it was wasteful (26.1%).

A small percentage (11.1%) of residents reported that a face shield or combination of mask and eye protection was unnecessary, and that glasses or goggles were sufficient protection.

Residency program recommendations on “always” wearing facial protection varied by procedure, according to the respondents, with surgery (79.7%) being the highest, followed by incision and drainage (51.6%) and intralesional injection (37.3%), with 10.5% of respondents reporting their program “always” advised the protocol during local anesthetic injection.

“Residency programs are, by definition, training arenas and habits acquired by residents who have the potential to impact them throughout the careers,” the researchers concluded. “Therefore, it is concerning that the authors’ survey results revealed that residency program recommendations for facial protection seem to vary significantly by procedure.

“Given the potential safety risk associated with facial splash, the authors encourage both residents and their respective residency programs to optimize splash safety guidelines during procedural dermatology.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.