Suppression of aerosol dispersion by highly viscoelastic poly(acrylic acid)- and poly(ethylene oxide)-based coolants during bone drilling

Abstract

Bone drilling in neurosurgical, dental, and orthopedic procedures, combined with the use of coolants, generates a dispersion of bone particles, coolants, and blood aerosols in the air. This poses the threat of airborne transmission of infectious diseases between patients and medical practitioners. Highly viscoelastic polymeric poly(acrylic acid) (PAA) and poly(ethylene oxide) (PEO) solutions of various concentrations were used as coolants during bone drilling at different mass flow rates to suppress aerosol generation, thereby mitigating the threat of cross-infection. The results revealed that the PAA and PEO solutions provide less advection than water and a comparable cooling performance. However, excessive viscoelasticity of PEO causes the fluid to rise along the cutting burr (the Weissenberg effect), thereby reducing the cooling coverage area. In contrast, slightly lower viscoelasticity of PEO results in a high cooling coverage area. The cooling coverage area is smaller for the PAA at 20 ml/min because the corresponding PAA solution easily swirls or splashes away from the drilling location. However, at 80 ml/min, the supplied PAA solution sufficiently cools the drilling area, despite the loss through splashing. The numbers of atomized droplets of water and the PAA and PEO solutions were quantified and compared to investigate the degree of aerosol formation and dispersion. The solution with the strongest viscoelasticity most significantly suppressed aerosolization and produced the fewest dispersed aerosol droplets during bone drilling.