Domestic electric drills in the service of orthopaedic surgery: a potential and preventable source of surgical site infections

Küçükdurmaz, Fatih; İmren, Yunus; Akkoyunlu, Yasemin; Tuncay, İbrahim; Şen, Cengiz

doi:10.3944/aott.2012.2794

Cited by 7 publications

(3 citation statements)

References 7 publications

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“…A most prevalent, yet highly theoretical risk faced by neurosurgeons is an airborne transmission of the virus resulting from the use of aerosol-generating instruments. These include all powered drills, [51][52][53] electrocautery, 51,54 lasers, 55 ultrasonic aspirators 56 as well as insufflators used for pneumoperitoneum maintenance during laparoscopic surgery. 57 To be infectious, aerosolized particles need to contain virions.…”

Section: Risk Related To Aerosol-generating Instruments On Virion-containing Tissuesmentioning

confidence: 99%

Letter: The Risk of COVID-19 Infection During Neurosurgical Procedures: A Review of Severe Acute Respiratory Distress Syndrome Coronavirus 2 (SARS-CoV-2) Modes of Transmission and Proposed Neurosurgery-Specific Measures for Mitigation

Iorio-Morin¹,

Hodaie²,

Sarica³

et al. 2020

Neurosurg.

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To the Editor:The novel coronavirus disease of 2019 (COVID-19) is a disease caused by the severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2). It was first reported in December 2019 as a series of cases of pneumonia with an unknown etiology clustered around a food market in Wuhan City, China. 1 The infection spread quickly and was declared a pandemic by the World Health Organization (WHO) on March 11, 2019. 2 By March 30, more than 782 365 confirmed cases were reported and a third of the world population were living in confinement to try to contain the virus. 3 While the disease itself is often mild, approximately 11% of cases require acute medical care, and this cohort quickly overwhelmed healthcare systems around the world. 4 In anticipation of such a demand, hospitals in many countries quickly stopped all nonurgent visits, procedures, and surgeries, freeing up beds, equipment, and workforce. 5 While neurosurgeons are not on the frontline of COVID-19 management and treatment, they commonly care for critically ill patients who will continue to present with subarachnoid hemorrhages, subdural hematomas, brain tumors, traumatic brain injuries, spinal cord injuries, and compressive myelopathies while the pandemic occurs. While public health measures such as quarantine and social distancing are proving effective at slowing the spread, 6,7 surgeons remain in direct contact with their patients throughout their operations. Protecting the surgical team from contracting COVID-19 is of utmost importance as they are both a potential vector for patient contamination and a scarce resource that cannot be easily replaced.The goal of this paper is to briefly review how SARS-CoV-2 is transmitted and propose measures that could be implemented to minimize the risk of contaminating the operating room (OR) personnel during the most common neurosurgical procedures. Methods and ethical considerations are discussed in the Supplemental Digital Content. SARS-COV-2 TRANSMISSION Sites of EntryPhylogenetic analysis revealed that the SARS-CoV-2 virus probably evolved from the bat SARS-like CoV (bat-SL-

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Section: Risk Related To Aerosol-generating Instruments On Virion-containing Tissuesmentioning

confidence: 99%

Letter: The Risk of COVID-19 Infection During Neurosurgical Procedures: A Review of Severe Acute Respiratory Distress Syndrome Coronavirus 2 (SARS-CoV-2) Modes of Transmission and Proposed Neurosurgery-Specific Measures for Mitigation

Iorio-Morin¹,

Hodaie²,

Sarica³

et al. 2020

Neurosurg.

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“…Although the study aimed at looking at risk of surgical site infection, one of the secondary outcomes demonstrated drills produced statistically significantly higher levels of particles than the ambient air ( p < 0.01). 19 …”

Section: Resultsmentioning

confidence: 99%

Aerosol generating procedures in trauma and orthopaedics in the era of the Covid-19 pandemic; What do we know?

et al. 2021

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Purpose COVID-19 pandemic has created havoc all over the globe and spared no one regardless of status, gender, location and ethnicity. There were questions raised if trauma and orthopaedic (T&O) procedures actually generated aerosols? The need for a review of literature highlighting the nature and impact of aerosol generation within T&O surgery was noted. Methods A comprehensive online search was performed for all published articles in the English language, evaluating AGPs in T&O surgery and the relevant personal protection equipment used. Results The search strategy populated 43 studies. Six studies were identified as duplicates. The shortlisted 37 studies were screened and nine studies were included in the review. An additional four studies were included from the bibliography review. Conclusion Most orthopaedic procedures are high-risk aerosol generating procedures (AGPs). Conventional surgical masks do not offer protection against high-risk AGPs. In the current era of COVID-19 pandemic, there is a significant risk to the transmission of infection to the theatre staff. For protection against airborne transmission, appropriate masks should be used. These need proper fitting and sizing to ensure full protection when used.

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“…The following three environments are considered when the risk of transmission of SARS-CoV-2 in the operating room is high: 30,31,36 1) all surgeries in which healthcare workers might be exposed to the respiratory or digestive tract; 2) endotracheal intubation and extubation; 37,38 3) all surgical procedures with aerosol-generating instruments from potentially virion-contaminated tissues; at this point, it is recommended to limit the use of these devices (motorized drills, electrocautery, [39][40][41][42] lasers, 43 and ultrasonic aspirators). 44 Given that most hospital settings have multiple operating rooms, it is highly recommended that all COVID-19confirmed and COVID-19-suspect patients are confined to designated operating rooms.…”

Section: Intraoperative Managementmentioning

confidence: 99%

Reconversion of neurosurgical practice in times of the SARS-CoV-2 pandemic: a narrative review of the literature and guideline implementation in a Mexican neurosurgical referral center

Díaz-Bello

Hernández-Hernández

Guinto-Nishimura

et al. 2020

Neurosurgical Focus

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OBJECTIVEThe coronavirus disease 2019 (COVID-19) pandemic has forced the modification of surgical practice worldwide. Medical centers have been adapted to provide an efficient arrangement of their economic and human resources. Although neurosurgeons are not in the first line of management and treatment of COVID-19 patients, they take care of patients with neurological pathology and potential severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Here, the authors describe their institutional actions against the pandemic and compare these actions with those in peer-reviewed publications.METHODSThe authors conducted a search using the MEDLINE, PubMed, and Google Scholar databases from the beginning of the pandemic until July 11, 2020, using the following terms: “Neurosurgery,” “COVID-19/SARS-CoV-2,” “reconversion/modification,” “practice,” “academy,” and “teaching.” Then, they created operational guidelines tailored for their institution to maximize resource efficiency and minimize risk for the healthcare personnel.RESULTSAccording to the reviewed literature, the authors defined the following three changes that have had the greatest impact in neurosurgical practice during the COVID-19 pandemic: 1) changes in clinical practices; 2) changes in the medical care setting, including modifications of perioperative care; and 3) changes in the academic teaching methodology.CONCLUSIONSThe Instituto Nacional de Neurología y Neurocirugía “Manuel Velasco Suárez” is one of the major referral centers for treating highly complex neurosurgical pathologies in Mexico. Its clinical and neurosurgical practices have been modified with the implementation of specific interventions against the spread of COVID-19. These practical and simple actions are remarkably relevant in the context of the pandemic and can be adopted and suited by other healthcare centers according to their available resources to better prepare for the next event.

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Domestic electric drills in the service of orthopaedic surgery: a potential and preventable source of surgical site infections

Abstract: Domestic electric drills are not safe and may be a direct source of surgical site infection, as the use or re-use of these drills during orthopaedic surgery increases the risk of infection with contaminated aerosols that are produced by these devices.

Cited by 7 publications

References 7 publications

Letter: The Risk of COVID-19 Infection During Neurosurgical Procedures: A Review of Severe Acute Respiratory Distress Syndrome Coronavirus 2 (SARS-CoV-2) Modes of Transmission and Proposed Neurosurgery-Specific Measures for Mitigation

Letter: The Risk of COVID-19 Infection During Neurosurgical Procedures: A Review of Severe Acute Respiratory Distress Syndrome Coronavirus 2 (SARS-CoV-2) Modes of Transmission and Proposed Neurosurgery-Specific Measures for Mitigation

Aerosol generating procedures in trauma and orthopaedics in the era of the Covid-19 pandemic; What do we know?

Reconversion of neurosurgical practice in times of the SARS-CoV-2 pandemic: a narrative review of the literature and guideline implementation in a Mexican neurosurgical referral center

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