Conservation of personal protective equipment for head and neck cancer surgery during <scp>COVID</scp>‐19 pandemic

Chow, Velda Ling Yu; Chan, Jimmy Yu Wai; Ho, Valerie Wai-Yee; Lee, George Chung Ching; Wong, Melody Man Kuen; Gao, Wei

doi:10.1002/hed.26215

Cited by 10 publications

(12 citation statements)

References 10 publications

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“…Although not a direct focus of this literature review, the stratification of PPE is worth mentioning before delving into the innovative solutions involving the creation of new PPE. Chow et al 29 found that droplet contamination was highest and most widespread during osteotomies, indicating that these types of surgeries warrant the most advanced PPE, while transoral robotic surgeries have the lowest risk of droplet contamination, suggesting that less stringent PPE is sufficient for providers during these procedures.…”

Section: Discussionmentioning

confidence: 99%

Innovations in otorhinolaryngology in the age of COVID‐19: A systematic literature review

McCarty

Soldatova

Brant

et al. 2022

World j. otorhinolaryngol.-head neck surg.

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Objective: Otolaryngologists are at increased occupational risk of Coronavirus Disease 2019 (COVID-19) infection due to exposure from respiratory droplets and aerosols generated during otologic, nasal, and oropharyngeal examinations and procedures. There have been a variety of guidelines and precautions developed to help mitigate this risk. While many reviews have focused on the personal protective equipment (PPE) and preparation guidelines for surgery in the COVID-19 era, none have focused on the more creative and unusual solutions designed to limit viral transmission. This review aims to fill that need.Data Sources: PubMed, Ovid/Medline, and Scopus Methods: A comprehensive review of literature was performed on September 28, 2020 using PubMed, Ovid/Medline, and Scopus databases. All English-language studies were included if they proposed or assessed novel interventions developed for Otolaryngology practice during the COVID-19 pandemic. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.Results: A total of 41 papers met inclusion criteria and were organized into 5 categories ('General Recommendations for Otolaryngologic Surgery', 'Equipment Shortage Solutions', 'Airway Procedures', 'Nasal Endoscopy and Skull Base Procedures', and 'Otologic Procedures'). Articles were summarized, highlighting the innovations created and evaluated during the COVID-19 pandemic. Creative solutions such as application of topical viricidal agents, make-shift mask filters, three-dimensional (3-D) printable adapters for headlights, aerosol containing separation boxes, and a variety of new draping techniques have been developed to limit the risk of COVID-19 transmission.Conclusions: Persistent risk of COVID-19 exposure remains high. Thus, there is an increased need for solutions that mitigate the risk of viral transmission during office procedures and surgeries, especially given that most COVID-19 positive patients present asymptomatically. This review examines and organizes creative solutions that have been proposed and utilized in the otolaryngology. These solutions have a

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Section: Discussionmentioning

confidence: 99%

Innovations in otorhinolaryngology in the age of COVID‐19: A systematic literature review

McCarty

Soldatova

Brant

et al. 2022

World j. otorhinolaryngol.-head neck surg.

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“…It had anti-fog and anti-glare properties with no hearing restrictions. Each face shield was put against a white background with 12 grids measuring 7 cm × 7 cm each to facilitate counting at maximal magnification [ 11 ]. Each plastic sheet was carefully removed and placed against a white background for counting.…”

Section: Methodsmentioning

confidence: 99%

Novel approach to reduce SARS-CoV-2 transmission during trans-oral robotic surgery

et al. 2021

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This study describes a novel approach in the reduction of SARS-CoV-2 transmission during trans-oral robotic surgery (TORS). Eight patients underwent TORS between 01 February 2020 and 07 September 2020. A sterile plastic sheet draped over sterile supports with water-tight seal around each cannula was used to create a sterile working space within which the robotic arms could freely move during operation. This set-up acts as an additional physical barrier against droplet and aerosol transmission. Operative diagnosis; droplet count and distribution on plastic sheet and face shields of console and assistant surgeons, and scrub nurse were documented. TORS tumour excision was performed for patients with suspected tonsillar tumour ( n = 3) and tongue base tumour ( n = 2). TORS tonsillectomy and tongue base mucosectomy was performed for cervical nodal metastatic carcinoma of unknown origin ( n = 3). Droplet contamination was noted on all plastic drapes ( n = 8). Droplet contamination was most severe over the central surface at 97.2% (91.7–100.0%), with the highest droplet count along the centre-most column where it overlies the site of operation in the oral cavity 33.3% ( n = 31). Droplet count decreased towards the periphery. Contamination rate was 2.8% (0.0–8.3%) over the right lateral surface. There was no droplet contamination over the vertex and left lateral surface of plastic drapes. No droplet contamination was noted on face shields of all parties. The use of sterile plastic drapes with water-tight seal around each robotic cannula can help reduce viral transmission to healthcare providers during TORS.

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“…Disposable caps should be preferred-personal surgical caps should not be used; if used, they should be washed and disinfected after the case. [54] Disposable foot protector/overshoe and waterproof surgical overalls should be worn, especially in cases where fluid contamination is thought to be high. Then, the hands should be washed, and at least an N95 mask should be put on.…”

Section: Preoperative Preparation Of the Operation Roommentioning

confidence: 99%

“…In the end, all cutting tools should be collected in a container in accordance with surgical procedures. [54,55] Many devices used during operations create a "smoke" by burning tissue microparticles, creating combustion products, and carbon dioxide suspension with the risk of aerosolizing infectious diseases. These devices include electrocautery, ultrasonic harmonic devices and lasers used for tissue ablation.…”

Section: Protection Of the Patient And The Team During The Surgerymentioning

confidence: 99%

Endocrine Surgery during the COVID-19 Pandemic: Recommendations from Endocrine Surgery Society of Turkey

et al. 2020

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The 2019 novel coronavirus disease (COVID-19) was initially seen in Wuhan, China, in December 2019. World Health Organization classified COVID-19 as a pandemic after its rapid spread worldwide in a few months. With the pandemic, all elective surgeries and non-emergency procedures have been postponed in our country, as in others. Most of the endocrine operations can be postponed for a certain period. However, it must be kept in mind that these patients also need surgical treatment, and the delay time should not cause a negative effect on the surgical outcome or disease process. It has recently been suggested that elective surgical interventions can be described as medically necessary, time-sensitive (MeNTS) procedures. Some guidelines have been published on proper and safe surgery for both the healthcare providers and the patients after the immediate onset of the COVID-19 pandemic. We should know that these guidelines and recommendations are not meant to constitute a position statement, the standard of care, or evidence-based/best practice. However, these are mostly the opinions of a selected group of surgeons. Generally, only life-threatening emergency operations should be performed in the stage where the epidemic exceeds the capacity of the hospitals (first stage), cancer and transplantation surgery should be initiated when the outbreak begins to be controlled (second stage), and surgery for elective cases should be performed in a controlled manner with suppression of the outbreak (third stage). In this rapidly developing pandemic period, the plans and recommendations to be made on this subject are based on expert opinions by considering factors, such as the course and biology of the disease, rather than being evidence-based. In the recent reports of many endocrine surgery associations and in various reviews, it has been stated that most of the cases can be postponed to the third stage of the epidemic. We aimed to evaluate the risk reduction strategies and recommendations that can help plan the surgery, prepare for surgery, protect both patients and healthcare workers during the operation and care for the patients in the postoperative period in endocrine surgery.

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Conservation of personal protective equipment for head and neck cancer surgery during COVID‐19 pandemic

Cited by 10 publications

References 10 publications

Innovations in otorhinolaryngology in the age of COVID‐19: A systematic literature review

Innovations in otorhinolaryngology in the age of COVID‐19: A systematic literature review

Novel approach to reduce SARS-CoV-2 transmission during trans-oral robotic surgery

Endocrine Surgery during the COVID-19 Pandemic: Recommendations from Endocrine Surgery Society of Turkey

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