1.1 Splashes
There is an overall 22.3-76.9% risk of contamination from blood and body fluid splash on protective eye shields during surgery.(2, 29-35) The risk depends on the type of surgery, proximity to the operative field, type of diathermy used, and is proportional to the length of procedure and intra-operative blood loss. Depending on the type of surgery, mask with visors may not protect adequate protection.(36) Sing VK et al reported contamination of both the surgeon’s and assistant’s face during orthopaedic surgery.(36)
Chong et al’s mathematical models have shown that prescription glasses alone prevents splashes: 100% laterally, 92.6% medially, 77.8% inferiorly and 0% superiorly.(37) Lateral contamination has been reported to occur in 5%.(31) Many HCW erroneously believe that prescription glasses is adequate protection. Many studies have found contamination on the inner surfaces of prescription glasses, with contamination rate higher in longer surgeries (>30 minutes).(6) Conjunctival contamination has been found in 83% of prescription glasses and no protection, 50% for surgical loupes, 30% of facemask with visor, 17% for hard plastic glasses, and 3% of disposable plastic glasses during simulation of splashed debris during orthopaedic surgical procedures.(38)
This represents a potential route of infection especially during surgery on the upper aerodigestive tract, where the SARS-nCoV-2 viral load is potentially high.