Analysis of droplet splatter patterns during Coblation tonsil surgery in
the Covid-19 pandemic
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.