A novel protective barrier for extremity surgeries during the COVID-19 pandemic

Abstract

To present a novel protective barrier for COVID-19 transmission and investigate its effectiveness in protection against spreading aerosols and droplets during extremity surgery. Methods: We enrolled 436 patients who underwent urgent and essential surgery on the upper and lower extremity using a novel protective barrier under wide-awake local anesthesia. All patients were investigated in detail for COVID-19 infection with anamnesis, symptom questionnaires, and the required tests before surgery. Patient satisfaction regarding comfort during the surgery behind the protective barrier was analyzed using a five-point Likert scale. The protective effect of the transparent barrier was quantitatively and experimentally analyzed using smoke and saline transmission tests in different clinic scenarios with and without the protective barrier. Results: A total of 345 patients with no signs of COVID-19 infection underwent surgery. Ninety-one suspected patients who had positive COVID-19 symptoms or close contact with a COVID-19 infected patient underwent COVID-19 tests before surgery. All patients underwent urgent surgical treatment on the upper and lower extremities, and easily tolerated and were satisfied with the protective barrier. There was a statistically significant reduction in smoke and saline particles when using the protective barrier (p<0.001). The addition of negative suction and oxygen to the protective barrier potentiated the protective effect (p<0. 001). Conclusions: Extremity surgeries, especially hand surgeries, are one of the most common surgical procedures during the COVID-19 pandemic. Our protective barrier significantly reduced aerosol particles in our experimental model and was successfully used in clinical practice during extremity surgery.