Needle scratch. Please answer Dr. Bob
Apr 18, 2009
While suturing a wound on a pt the needle went through my glove and scratched my thumb. I did not bleed even though I squeezed the hell outta my thumb. The pts mother insisted that the pt was HIV negative and refused to have him tested (he was 14). The ID doc said that because the needle only scratched my thumb and did not draw blood PEP was not warranted. What do you think Dr. Bob?
Response from Dr. Frascino
I agree with the I.D. doc. PEP is not warranted for several reasons:
1. Suture needles are solid and less likely to transmit bloodborne pathogens than hollow-bore needles/syringes.
2. Your scratch was very slight. It did not bleed, even with pressure. The suture needle also had to pass through your glove before it came in contact with your thumb, which would further decrease the risk.
3. The source patient was extremely low risk (14-year-old boy).
To put any residual fears to rest you could get HIV-antibody tests per protocol for occupational exposures (baseline, three months, six months). However, I'm very confident you did not contract HIV from this incident.
If you would like to learn more about occupational exposures and indications for PEP, download a copy of the updated guidelines at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5409a1.htm.
Be well. Stay well.
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