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Is the ultrasonic scalpel recommended in head and neck surgery during the COVID ‐19 pandemic? State‐of‐the‐ art review
Author(s) -
MayoYánez Miguel,
CalvoHenríquez Christian,
Lechien Jérôme R.,
Fakhry Nicolas,
Ayad Tareck,
ChiesaEstomba Carlos M.
Publication year - 2020
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.26278
Subject(s) - respirator , covid-19 , pandemic , personal protective equipment , ultrasonic sensor , medicine , airway management , surgery , airway , intensive care medicine , infectious disease (medical specialty) , pathology , chemistry , radiology , disease , organic chemistry
Background Guidelines for ultrasonic devices use are imperative because infectious aerosols arising from airway procedures were a key etiologic factor in prior coronavirus outbreaks. This manuscript aims to summarize the available recommendations and the most relevant concepts about the use of ultrasonic scalpel during the SARS‐CoV‐2 pandemic. Methods Literature review of manuscripts with patients, animal models, or in vitro studies where the ultrasonic scalpel was used and the plume produced was analyzed in a quantitative and/ or qualitative way. Discussion Activated devices with tissue produce a biphasic bioaerosol composed (size 68.3‐994 nm) of tissue particles, blood, intact and no viable cells, and carcinogenic or irritant hydrocarbons (benzene, ethylbenzene, styrene, toluene, heptene, and methylpropene). Conclusion It is imperative to use an active smoke evacuator, to avoid ultrasonic scalpel use in COVID‐19 positive patients and in upper airway surgery, as well as to follow the protection recommendations of the guidelines for management this type of patients.