Use of a novel drape ‘tent’ as an infection prevention control measure for mastoid surgery

Lawrence, Rachael; O’Donoghue, Gerard M.; Kitterick, Pádraig T.; Hartley, Douglas E. H.

doi:10.1017/s0022215120002637

Cited by 3 publications

(3 citation statements)

References 13 publications

(33 reference statements)

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“…Using additional "tent" microscope drapes and patient isolation enclosures during aerosol-generating procedures provides physical barriers that may protect operating room personnel. [35][36][37][38][39][40][41][42][43] Nonetheless, a physical barrier method can only be implemented in surgeries during which patients are fully anesthetized and intubated; thus, it is not applicable to awake neurosurgery. Recent emergence of increased applications of the three-dimensional exoscope has also provided the ability to perform microsurgery while donning full PAPR respirators, as has been suggested by the otorhinolaryngology field.…”

Section: Discussionmentioning

confidence: 99%

Awake craniotomy for glioblastoma in COVID-19–positive patients and delivering the standard of care: illustrative case

Alvarez

Kotecha

McDermott

et al. 2021

Journal of Neurosurgery: Case Lessons

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BACKGROUND Providing the standard of care to patients with glioblastoma (GBM) during the novel coronavirus of 2019 (COVID-19) pandemic is a challenge, particularly if a patient tests positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Further difficulties occur in eloquent cortex tumors because awake speech mapping can theoretically aerosolize viral particles and expose staff. Moreover, microscopic neurosurgery has become difficult because the use of airborne-level personal protective equipment (PPE) crowds the space between the surgeon and the eyepiece. However, delivering substandard care will inevitably lead to disease progression and poor outcomes. OBSERVATIONS A 60-year-old man with a left insular and frontal operculum GBM was found to be COVID-19 positive. Treatment was postponed pending a negative SARS-CoV-2 result, but in the interim, he developed intratumoral hemorrhage with progressive expressive aphasia. Because the tumor was causing dominant hemisphere language symptomatology, an awake craniotomy was the recommended surgical approach. With the use of airborne-level PPE and a surgical drape to protect the surgeon from the direction of potential aerosolization, near-total gross resection was achieved. LESSONS Delaying the treatment of patients with GBM who test positive for COVID-19 will lead to further neurological deterioration. Optimal and timely treatment such as awake speech mapping for COVID-19–positive patients with GBM can be provided safely.

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Section: Discussionmentioning

confidence: 99%

Awake craniotomy for glioblastoma in COVID-19–positive patients and delivering the standard of care: illustrative case

Alvarez

Kotecha

McDermott

et al. 2021

Journal of Neurosurgery: Case Lessons

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“…We describe a waterproof method of draping for major ear surgery which ensures continued isolation of the operative field throughout major ear surgery and allows the collection of irrigation fluid in a reservoir. This method of draping is compatible with recently developed COVID-19 isolation chambers and drapes such as the COVID-19 Airway Management Isolation Chamber (CAMIC) and drape 'tent' recently described in the literature [2,3]. We received approval from our Institutional Research and Innovation Department (approval number: 2021/GAP/21) to involve human participants and procedures in our study.…”

Section: Introductionmentioning

confidence: 99%

A Tried and Tested Waterproof Draping Method for Major Ear Surgery

Hickson¹,

Momin²,

Asnani³

et al. 2022

Cureus

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Preparing and maintaining a clean operative field is the standard of care in all surgical fields globally. Major ear surgery has its own challenges such as the long surgical procedure time and the tricky local anatomical landscape. A waterproof method of draping for major ear surgery is described in this technical report. This method allows for the collection of irrigation fluid in a reservoir while maintaining continued isolation of the operative field during surgery. We discuss the advantages of using a 3M Steri-Drape TM Aperture Pouch Drape to square the surgical site and create a pouch dedicated to irrigation fluid. Following that, running locking stitches are performed for further reinforcement of the adhesion to the skin, often done in longer procedures. We have identified a technique to ensure better draping. In over 150 cases draped in this method, we have not witnessed drape edge lift, water ingress, or skin avulsion/injury.

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“…Lawrence et al ., in this month's issue, continue this theme by illustrating a novel drape ‘tent’ method for use in mastoid surgery. 5…”

mentioning

confidence: 99%

The end of an unforgettable year

Fishman¹,

Fisher²

2020

J. Laryngol. Otol.

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This year has been dominated by the coronavirus disease 2019 (Covid-19) pandemic. Without doubt it has resulted in significant disruption to our lives, existing practices and our specialty. Alongside this, there has been a surge in journal submissions for coronavirus-themed articles. It is through medical journals such as ours that published, peer-reviewed evidence can be rapidly shared on a global scale, which is so important in a pandemic such as this. Throughout this year, coronavirus-related articles have been fast-tracked within our peer review process, and we thank everyone involved at The Journal of Laryngology & Otology for making this possible. Otolaryngology as a specialty has been particularly hard hit by the Covid-19 pandemic given the close-up nature of our specialty to virion-loaded mucosal surfaces in the upper airways. Virtual (remote) clinics and videoconferencing have taken an increasing precedence since the pandemic was declared, and this theme is continued within this issue. 1-4 In addition, special precautions, use of personal protective equipment and novel techniques have been developed for aerosol-generating procedures in otolaryngology. Lawrence et al., in this month's issue, continue this theme by illustrating a novel drape 'tent' method for use in mastoid surgery. 5 We have published a substantial number of articles this year linking Covid-19 infection with smell and taste disturbances. 6-10 We end the year with a tour-de-force article in this month's issue investigating the olfactory epithelium at the microscopic level in Covid-19 anosmia cases, in an attempt to elucidate the pathogenesis of olfactory dysfunction in Covid-19 infection. 11 Histological findings demonstrate significant disruption and desquamation of the surface olfactory epithelium. The authors hypothesise that failure of epithelial repair leads to thinning and loss of the olfactory dendrites.

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Use of a novel drape ‘tent’ as an infection prevention control measure for mastoid surgery

Cited by 3 publications

References 13 publications

Awake craniotomy for glioblastoma in COVID-19–positive patients and delivering the standard of care: illustrative case

Awake craniotomy for glioblastoma in COVID-19–positive patients and delivering the standard of care: illustrative case

A Tried and Tested Waterproof Draping Method for Major Ear Surgery

The end of an unforgettable year

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