Conservation of personal protective equipment for head and neck cancer surgery during COVID-19 pandemic

Head Neck. 2020 Jun;42(6):1187-1193. doi: 10.1002/hed.26215. Epub 2020 Apr 29.

Abstract

Background: COVID-19 pandemic has led to a global shortage of personal protective equipment (PPE). This study aims to stratify face shield needs when performing head and neck cancer surgery.

Methods: Fifteen patients underwent surgery between March 1, 2020 and April 9, 2020. Operative diagnosis and procedure; droplet count and distribution on face shields were documented.

Results: Forty-five surgical procedures were performed for neck nodal metastatic carcinoma of unknown origin (n = 3); carcinoma of tonsil (n = 2), tongue (n = 2), nasopharynx (n = 3), maxilla (n = 1), and laryngopharynx (n = 4). Droplet contamination was 57.8%, 59.5%, 8.0%, and 0% for operating, first and second assistant surgeons, and scrub nurse respectively. Droplet count was highest and most widespread during osteotomies. No droplet splash was noted for transoral robotic surgery.

Conclusion: Face shield is not a mandatory adjunctive PPE for all head and neck surgical procedures and health care providers. Judicious use helps to conserve resources during such difficult times.

Keywords: COVID-19; PPE; conservation; face shield; head and neck cancer.

MeSH terms

  • COVID-19
  • Centers for Disease Control and Prevention, U.S. / standards
  • Cohort Studies
  • Communicable Disease Control / methods
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / prevention & control
  • Equipment Safety
  • Female
  • Humans
  • Infectious Disease Transmission, Patient-to-Professional / prevention & control*
  • Male
  • Monitoring, Intraoperative / methods*
  • Occupational Health*
  • Operating Rooms / standards
  • Pandemics / prevention & control
  • Pandemics / statistics & numerical data*
  • Personal Protective Equipment / standards
  • Personal Protective Equipment / virology*
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / prevention & control
  • Practice Guidelines as Topic
  • Retrospective Studies
  • United States