Quantifying Aerosol Generation in Maxillofacial Trauma Repair Techniques.

IF 0.8 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Craniomaxillofacial Trauma & Reconstruction Pub Date : 2022-12-01 Epub Date: 2021-12-29 DOI:10.1177/19433875211059314
Adam McCann, Kyle Singerman, James Coxe, John Singletary, Jun Wang, Ryan Collar, Tsung-Yen Hsieh
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Abstract

Study design: Cadaveric simulation study.

Objective: The novel coronavirus (COVID-19), which can be transmitted via aerosolized viral particles, has directed focus on protection of healthcare workers during procedures involving the upper aerodigestive tract, including maxillofacial trauma repair. This study evaluates particle generation at different distances from open reduction and internal fixation (ORIF) of maxillofacial injuries in the intraoperative setting to reduce the risk of contracting airborne diseases such as COVID-19.

Methods: Two cadaveric specimens in a simulated operating room underwent ORIF of midface and mandible fractures via intraoral incisions as well as maxillomandibular fixation (MMF) using hybrid arch bars. ORIF was performed with both self-drilling screws and with the use of a power drill for creating guide holes. Real-time aerosol concentration was measured throughout each procedure using 3 particle counters placed 0.45, 1.68, and 3.81 m (1.5, 5.5, and 12.5 feet, respectively) from the operative site.

Results: There was a significant decrease in particle concentration in all procedures at 1.68 m compared to 0.45 m, but only 2 of the 5 procedures showed further significant decrease in particle concentration when going from 1.68 to 3.81 m from the operative site. There was significantly less particle concentration generated at all distances when using self-drilling techniques compared to power drilling for ORIF.

Conclusions: Consideration of using self-drilling screwing techniques as well as maintaining physical distancing protocols may decrease risk of transmission of airborne diseases such as COVID-19 while in the intraoperative setting.

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颌面部创伤修复技术中气溶胶产生的定量分析。
研究设计:尸体模拟研究。目的:新型冠状病毒(COVID-19)可通过雾化病毒颗粒传播,已成为医护人员在包括颌面创伤修复在内的上呼吸道消化道手术过程中的保护重点。本研究评估术中颌面部损伤在切开复位和内固定(ORIF)不同距离下产生的颗粒,以降低感染COVID-19等空气传播疾病的风险。方法:在模拟手术室对2例尸体标本进行中、下颌骨骨折经口内切开ORIF和混合弓棒固定(MMF)。ORIF采用自钻螺钉和电钻制造导向孔。在每次操作过程中,使用3个粒子计数器实时测量气溶胶浓度,分别放置在距离操作地点0.45、1.68和3.81 m(分别为1.5、5.5和12.5英尺)处。结果:与0.45 m相比,在1.68 m处,所有手术的颗粒浓度均显著降低,但在距离手术部位1.68 m至3.81 m处,5个手术中只有2个手术的颗粒浓度进一步显著降低。与ORIF的动力钻井相比,使用自钻技术在所有距离上产生的颗粒浓度都明显减少。结论:术中考虑使用自钻螺钉技术并保持身体距离可降低COVID-19等空气传播疾病的传播风险。
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Craniomaxillofacial Trauma & Reconstruction
Craniomaxillofacial Trauma & Reconstruction DENTISTRY, ORAL SURGERY & MEDICINE-
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