CJD Question

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From:Brown Alex <Alex.Brown@aaaht.scot.nhs.uk>
To:HistoNet <Histonet@pathology.swmed.edu>
Reply-To:
Content-Type:text/plain

	At the risk of incurring wrath, but promoting discussion, I have to
agree with Glyn on this issue. As a general rule we will not perform a
frozen section on patients known to have active TB, HIV, hepatitis or CJD
either.

1)  I agree that 'good laboratory practice' and appropriate safety measures
should protect the operator from any real risk of infection - barring
acidents of course ( which do happen! )
2)  We have two cryostats in the lab.  If we had to defrost and clean one of
them due to having sectioned 'infective' material, and Sod's Law ( aka
Murphy's Law ), received a second case of 'infected tissue' ,what would we
do ??  Refuse to deal with the second case ??  In a busy District General
Hospital it would unacceptable to have both cryostats out of commission at
the same time. Yet how do you justify accepting one case for frozen but not
the other ?
3)  I accept that we may well be handling tissues from 'infective' patients
unknowingly, however that is part and parcel of the everyday risks we accept
in this profession. It seems to me however that we should minimise those
risks where practical and where possible. The inconvenience caused to the
surgical team and the slight , if any , additional discomfort or risk to the
patient, is to me a more acceptable alternative to potentially infecting a
member of my staff with a fatal illness.
	
		Alex. Brown
		Crosshouse Hospital
		Kilmarnock, Scotland.



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