We appreciate the comments of Rieger and colleagues in reference to our recent article on the risk of HCV transmission from medical staff to patients. Based on their own yet unpublished results regarding glove perforation rates in cardiovascular surgery, the authors claim that our model-based calculations might represent an underestimation of the existing risk. In reply, we would like to address 2 points.
First, depending on the surgical speciality and the method used to test the integrity of surgical gloves, a wide range of glove perforation rates was recorded. These data, however, are not necessarily relevant for estimates of infectious disease transmission,1 since glove perforations are not always the result of injuries caused by sharp surgical instruments. For instance, in a study among surgical personnel of a tertiary care center, 26% of all glove tears in which the underlying mechanism was known did not involve sharp instruments.2 Hence, the rate of glove perforations detected at the end of an invasive procedure and the frequency of percutaneous injuries contracted by the team during this operation need not be identical.