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Analysis of droplet splatter patterns during Coblation tonsil surgery in the Covid-19 pandemic
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  • Grace Khong,
  • Jaya Bhat,
  • Ravi Sharma,
  • Samuel Leong
Grace Khong
Alder Hey Children's NHS Foundation Trust
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Jaya Bhat
Alder Hey Children's NHS Foundation Trust
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Ravi Sharma
Alder Hey Children's NHS Foundation Trust
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Samuel Leong
Liverpool University Hospitals NHS Foundation Trust
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Abstract

Objectives: To assess droplet splatter around the surgical field and surgeon during simulated Coblation tonsil surgery to better inform on mitigation strategies and evaluate choice of personal protective equipment. Design: Observational study Setting: Operation theatre suite at a tertiary hospital Participants: Life size head model was used to simulate tonsil surgery using fluorescein-soaked strawberries to mimic tonsils Main outcome measures: The Coblation wand was activated over the strawberries for 5 minutes. This was repeated 5 times with 2 surgeons (total of 10 data sets). The presence of droplet around the surgical field and anatomical subsites on the surgeon was assessed in binary fashion: present or not present. The results were collated as frequency of droplet detection and illustrated as a heatmap; 0 = white, 1-2 = yellow, 3-4 = orange and 5 = red. Results: Fluorescein droplets were detected in all four quadrants of the surgical field. The frequency of splatter was greatest in the upper (nearest to surgeon) and lower quadrants. There were detectable splatter droplets on the surgeon; most frequently occurring on the hands followed by the forearm. Droplets were also detected on the visor, neck, and chest albeit less frequently. However, none were detected on the upper arms. Conclusion: Droplet splatter can be detected in the immediate surgical field as well as on the surgeon. Although wearing a face visor does not prevent splatter on the surgical mask or around the eyes, it should be considered when undertaking tonsil surgery as well as a properly fitted goggle.