Do modern spectacles endanger surgeons? The Waikato Eye Protection Study.

BACKGROUND: Despite documented cases of infectious disease transmission to medical staff via conjunctival contamination and widespread recommendation of protective eyewear use during surgical procedures, a large number of surgeons rely on their prescription spectacles as sole eye protection. Modern fashion spectacles, being of increasingly slim design, may no longer be adequate in this role. METHODS: A survey was conducted among the surgeons at Waikato Hospital from December 7, 2004 to February 1, 2005, to assess current operating theater eyewear practices and attitudes. Those who wore prescription spectacles were asked to assume a standardized "operating position" from which anatomic measurements were obtained. These data were mathematically analyzed to determine the degree of palebral fissure protection conferred by their spectacles. RESULTS: Of 71 surgical practitioners surveyed, 45.1% required prescription lenses for operating, the mean spectacle age being 2.45 years; 84.5% had experienced prior periorbital blood splashes; 2.8% had previously contracted an illness attributed to such an event; 78.8% participants routinely used eye protection, but of the 27 requiring spectacles, 68.0% used these as their sole eye protection. Chief complaints about safety glasses and facial shields were of fogging, poor comfort, inability to wear spectacles underneath, and unavailability. Our model predicted that 100%, 92.6%, 77.8%, and 0% of our population were protected by their spectacles laterally, medially, inferiorly, and superiorly, respectively. CONCLUSIONS: Prescription spectacles of contemporary styling do not provide adequate protection against conjunctival blood splash injuries. Our model predicts the design adequacy of currently available purpose-designed protective eyewear, which should be used routinely.

Nasal fractures: a study comparing local and general anaesthesia techniques.

BACKGROUND: The objective of the present study was to examine the outcome of nasal fracture reduction under both local anaesthesia and general anaesthesia techniques. METHODS: Patient records were obtained from clinic lists of patients attending the otolaryngology (ORL) outpatient unit at Wellington Hospital or the plastic surgical unit at Hutt Hospital over a 24-month period. To meet criteria for inclusion, patients had to have an isolated nasal deformity, be aged 14 years or older and be at least 6 months post reduction. Functional and aesthetic results were assessed using subjective and objective end outcome measures. A questionnaire was developed and used to assess subjective outcomes. The number of patients proceeding to open operative correction was used for the objective measure, which included septoplasty, septorhinoplasty or rhinoplasty. RESULTS: A total of 197 patients had nasal fractures manipulated over this period. One hundred and seven were manipulated under general anaesthesia (GA) and 90 were manipulated under local anaesthesia (LA). The questionnaire completion rate was 66%. Patient demographics were statistically similar between the two groups. There was no statistical difference in patients" subjective assessment of outcome with treatment by GA or LA. More patients preferred to have their fracture manipulated under GA but this was not statistically significant. There was no significant difference between GA and LA groups in progression to open operative correction. CONCLUSIONS: Both LA and GA appear to be acceptable and satisfactory methods of anaesthesia in the reduction of simple displaced nasal fracture.