Minimising aerosol generation during orthopaedic surgical procedures- Current practice to protect theatre staff during Covid-19 pandemic

Raghavan, Roshan; Middleton, Paul R.; Mehdi, Ali

doi:10.1016/j.jcot.2020.04.024

Cited by 30 publications

(39 citation statements)

References 4 publications

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“…Several other articles have been published on the necessary reorganization of surgical departments during the COVID-19 pandemic and the decline in surgical activity resulting from the medical measures implemented in response to this pandemic 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 . However, none of them has precisely evaluated the decline in trauma cases, and especially in maxillofacial trauma cases.…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 lockdown on the epidemiology of maxillofacial trauma activity: a French multicentre comparative study

Boutray

Kün‐Darbois

Sigaux

et al. 2021

International Journal of Oral and Maxillofacial Surgery

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The coronavirus disease 2019 (COVID-19) outbreak has had a major impact on medical and surgical activities. A decline in facial trauma incidence was noticed during the lockdown period. The aim of this study was to evaluate the decline in maxillofacial trauma in France during this particular period. A retrospective multicentre comparative study was initiated in 13 major French public hospital centres. The incidence of facial trauma requiring surgery during the first month of lockdown was compared to that during equivalent periods in 2018 and 2019. Differences in the types of trauma were also analysed. Thirteen maxillofacial departments participated in the study. A significant decline in maxillofacial trauma volumes was observed when compared to equivalent periods in 2018 and 2019 (106 patients compared to 318 and 296 patients, respectively), with an average reduction of 65.5% ( P = 0.00087). The proportion of trauma due to sports and leisure was reduced when compared to reports in the literature. As a consequence, in the context of a pandemic, the material and human resources related to this activity could be reallocated to the management of other pathologies that cannot be postponed.

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Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 lockdown on the epidemiology of maxillofacial trauma activity: a French multicentre comparative study

Boutray

Kün‐Darbois

Sigaux

et al. 2021

International Journal of Oral and Maxillofacial Surgery

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“…It may be that virtual and telephone consultations will have to become the new "normal" in outpatient services until an effective treatment or vaccination for COVID-19 can be implemented. Ensuring the operating theatre remains safe for staff, especially where aerosol generation risk is high, will require additional steps in cleaning and utilisation of personal protective equipment [10]. This will increase turnover times between cases and reduce list utilisation.…”

Section: Discussionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on orthopaedic services and training in the UK

Khan

Williamson

Trompeter

2020

Eur J Orthop Surg Traumatol

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Introduction The novel coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organisation on 11 March 2020. The aim of this study is to assess the impact of COVID-19 on orthopaedic practice and training in the UK. Methods Surgeons throughout UK hospitals were asked to complete an electronic survey relating to orthopaedic practice and training in their hospital. The nationwide survey was conducted during the first peak of COVID-19 cases in the UK between

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“…The aerosols generating procedures in orthopedic surgery include the use of electrocautery, high-speed burr, ultrasonic devices, and power tools like an oscillating saw, drills, reamers, and pulse lavage [12]. While it is unknown if the COVID-19 particles can survive electrocautery, minimizing the amount of smoke in the operating room helps in decreasing potential transmission.…”

Section: Discussionmentioning

confidence: 99%

“…The surgical knife was used for dissection and electrocautery was minimally used with suction wherever required to minimize aerosol generation. Kerrison rongeur, nibblers, and osteotomes were used in place of burr or harmonic scalpel which decreased the aerosol generation [12].…”

Section: Precautions In the Operation Theatrementioning

confidence: 99%

Adapting Policy Guidelines for Spine Surgeries During COVID-19 Pandemic in View of Evolving Evidences: An Early Experience From a Tertiary Care Teaching Hospital

Verma¹,

Nagar²,

Jain³

et al. 2020

Cureus

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Eight patients (61.5%) presented with spinal cord injury (SCI) due to vertebral fracture with fall from height (87.5%) as the most common etiology. Among the traumatic SCI patients, six (75%) were managed surgically with posterior decompression and instrumented fusion with pedicle screws while two patients (25%) were managed conservatively. There were four patients (30.8%) of tuberculosis of the spine of whom two (50%) were managed with posterior decompression, debridement, and stabilization with pedicle screws, samples for culture, biopsy, and cartridge-based nucleic acid amplification test (CBNAAT) were collected during the procedure; for the remaining two patients (50%), a trans-pedicular biopsy was performed to confirm the diagnosis for initiation of anti-tubercular therapy. Prolapsed intervertebral disc causing cauda equina syndrome was the reason for emergency surgery in one patient (7.7%). COVID-19 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) test was performed in four patients (30.8%), in whom the most common symptom was fever (two patients (50%)). These patients were residents of high prevalence area for COVID-19 infection. Sore throat (25%), fatigue (25%), and low oxygen saturation (25%) were present in one patient which prompted us to get the COVID-19 test. All patients were reported negative for COVID-19. Conclusion The structural organization and the management protocol we describe allowed us to reduce infection risk and ultimately hospital stay, thereby maximizing the already stretched available medical resources. These precautions helped us to reduce transmission and exposure to COVID-19 in health care workers (HCW) and patients in our institute. The aim of this article is that our early experience can be of value to the medical communities that will soon be in a similar situation.

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Minimising aerosol generation during orthopaedic surgical procedures- Current practice to protect theatre staff during Covid-19 pandemic

Cited by 30 publications

References 4 publications

Impact of the COVID-19 lockdown on the epidemiology of maxillofacial trauma activity: a French multicentre comparative study

Impact of the COVID-19 lockdown on the epidemiology of maxillofacial trauma activity: a French multicentre comparative study

The impact of the COVID-19 pandemic on orthopaedic services and training in the UK

Adapting Policy Guidelines for Spine Surgeries During COVID-19 Pandemic in View of Evolving Evidences: An Early Experience From a Tertiary Care Teaching Hospital

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