Blood splash from different diathermy instruments during tonsillectomy

Hanna, Brendan; Thompson, Peter; Smyth, Calvin M.; Gallagher, Geraldine

doi:10.1017/s0022215106001666

Cited by 2 publications

(2 citation statements)

References 4 publications

(6 reference statements)

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“…Previous studies, undertaken during actual surgery (in vivo), have focused on either the monopolar or bipolar diathermy which clearly demonstrated splatter contamination on the surgeon's face. [1][2][3] Bipolar diathermy resulted in greater splatter. These studies were published following concerns that transconjunctival exposure was a potential route of transmission for hepatitis viruses and the human immunodeficiency virus in health care workers.…”

Section: Discussionmentioning

confidence: 99%

“…Blood splatter contamination occurring on the surgeon during tonsil surgery is well recognized in the literature. 1,2 In fact, tonsillectomy was the procedure most commonly resulting in patient's blood and secretions being detected on the surgeon's face. 3 The current Covid-19 pandemic has highlighted many routine ENT operations, including tonsillectomy, as being an aerosol-generating procedure (AGP).…”

Section: Introductionmentioning

confidence: 99%

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Analysis of Droplet Splatter Patterns During Coblation Tonsil Surgery in the Covid-19 Pandemic

Khong

Bhat

Sharma

et al. 2021

Ann Otol Rhinol Laryngol

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Objectives: To assess droplet splatter around the surgical field and surgeon during simulated Coblation tonsil surgery to better inform on mitigation strategies and evaluate choice of personal protective equipment. Methods: This was an observational study performed using a life-size head model to simulate tonsil surgery and fluorescein-soaked strawberries to mimic tonsils. The Coblation wand was activated over the strawberries for 5 minutes. This was repeated 5 times with 2 surgeons (totalling 10 data sets). The presence of droplet around the surgical field and anatomical subsites on the surgeon was assessed in binary fashion: present or not present. The results were collated as frequency of droplet detection and illustrated as a heatmap; 0 = white, 1-2 = yellow, 3-4 = orange, and 5 = red. Results: Fluorescein droplets were detected in all 4 quadrants of the surgical field. The frequency of splatter was greatest in the upper (nearest to surgeon) and lower quadrants. There were detectable splatter droplets on the surgeon; most frequently occurring on the hands followed by the forearm. Droplets were also detected on the visor, neck, and chest albeit less frequently. However, none were detected on the upper arms. Conclusion: Droplet splatter can be detected in the immediate surgical field as well as on the surgeon. Although wearing a face visor does not prevent splatter on the surgical mask or around the eyes, it should be considered when undertaking tonsil surgery as well as a properly fitted goggle. Level of evidence: 5

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Analysis of Droplet Splatter Patterns During Coblation Tonsil Surgery in the Covid-19 Pandemic

Khong

Bhat

Sharma

et al. 2021

Ann Otol Rhinol Laryngol

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A prospective study of blood splatter in ENT

Lakhani

Loh

Zhang

et al. 2015

Eur Arch Otorhinolaryngol

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Surgeons face an occupational risk of daily exposure to blood and body fluids. Potential sources of infection include sharps injuries and mucocutaneous contact. The transmission of blood-borne viruses, in particular human immunodeficiency virus (HIV), Hepatitis B and Hepatitis C from the patient to healthcare workers is well documented in the literature. We studied the incidence and degree of blood splash in all otolaryngology (ENT) procedures undertaken in a single unit over a 12 week period. In addition, we investigated which intraoperative factors might predict the degree of splash. We undertook a prospective, non-blinded study of 102 patients undergoing a range of 'routine' elective ENT within one department over 12 weeks. A surgical mask with visor attached was worn in all procedures. Following each procedure, all splatter masks were collected and examined macroscopically and microscopically for blood splash. In addition, the procedure performed, technique used, total blood loss, operating time and grade of surgeon was noted. 54% of procedures resulted in splash mask contamination. The median number of splash spots per mask was 4.7 (range 0-63). Tonsillectomy was the most commonly performed procedure, accounting for over one-third of total procedures investigated. Each mask had an average of 8.2 splash marks. Tonsillectomy had a splash rate of 76.9%. Although the risk of developing HIV is low the operating surgeon has a duty to take all precautions to protect themselves during a procedure and therefore a protective mask and visor or suitable goggles must be worn.

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Blood splash from different diathermy instruments during tonsillectomy

Abstract: The use of disposable bipolar diathermy for haemostasis during tonsillectomy poses a greater risk of conjunctival contamination for the surgeon than using reusable monopolar diathermy.

Cited by 2 publications

References 4 publications

Analysis of Droplet Splatter Patterns During Coblation Tonsil Surgery in the Covid-19 Pandemic

Analysis of Droplet Splatter Patterns During Coblation Tonsil Surgery in the Covid-19 Pandemic

A prospective study of blood splatter in ENT

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