In vitro comparison of surgical techniques in times of the SARS-CoV-2 pandemic: electrocautery generates more droplets a
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In vitro comparison of surgical techniques in times of the SARS‑CoV‑2 pandemic: electrocautery generates more droplets and aerosol than laser surgery or drilling Daniela B. Guderian1 · Andreas G. Loth1 · Roxanne Weiß1 · Marc Diensthuber1 · Timo Stöver1 · Martin Leinung1 Received: 9 July 2020 / Accepted: 28 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Introduction Based on current knowledge, the SARS-CoV-2 is transmitted via droplet, aerosols and smear infection. Due to a confirmed high virus load in the upper respiratory tract of COVID-19 patients, there is a potential risk of infection for health care professionals when performing surgical procedures in this area. The aim of this study was the semi-quantitative comparison of ENT-typical interventions in the head and neck area with regard to particle and aerosol generation. These data can potentially contribute to a better risk assessment of aerogenic SARS-CoV-2-transmission caused by medical procedures. Materials and methods As a model, a test chamber was created to examine various typical surgical interventions on porcine soft and hard tissues. Simultaneously, particle and aerosol release were recorded and semi-quantitatively evaluated timedependently. Five typical surgical intervention techniques (mechanical stress with a passive instrument with and without suction, CO2 laser treatment, drilling and bipolar electrocoagulation) were examined and compared regarding resulting particle release. Results Neither aerosols nor particles could be detected during mechanical manipulation with and without suction. The use of laser technique showed considerable formation of aerosol. During drilling, mainly solid tissue particles were scattered into the environment (18.2 ± 15.7 particles/cm2/min). The strongest particle release was determined during electrocoagulation (77.2 ± 30.4 particles/cm2/min). The difference in particle release between electrocoagulation and drilling was significant (p
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