Conservation of personal protective equipment for head and neck cancer surgery during COVID‐19 pandemic

• Published in: Head & Neck 2020-06, Vol.42 (6), p.1187-1193
• Main Authors: Chow, Velda Ling Yu, Chan, Jimmy Yu Wai, Ho, Valerie Wai Yee, Lee, George Chung Ching, Wong, Melody Man Kuen, Wong, Stanley Thian Sze, Gao, Wei
• Format: Article
• Language: English
• Subjects: Cancer surgery; Centers for Disease Control and Prevention, U.S. - standards; Cohort Studies; Communicable Disease Control - methods; conservation; Contamination; Coronavirus Infections - epidemiology; Coronavirus Infections - prevention & control; COVID-19; Equipment Safety; face shield; Female; Head & neck cancer; Head and Neck Cancer; Humans; Infectious Disease Transmission, Patient-to-Professional - prevention & control; Male; Maxilla; Metastases; Monitoring, Intraoperative - methods; Nasopharynx; Occupational Health; Operating Rooms - standards; Pandemics; Pandemics - prevention & control; Pandemics - statistics & numerical data; Personal protective equipment; Personal Protective Equipment - standards; Personal Protective Equipment - virology; Pneumonia, Viral - epidemiology; Pneumonia, Viral - prevention & control; PPE; Practice Guidelines as Topic; Retrospective Studies; Robotic surgery; Special Issue; Tonsil; United States
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.26215

Background COVID‐19 pandemic has led to a global shortage of personal protective equipment (PPE). This study aims to stratify face shield needs when performing head and neck cancer surgery. Methods Fifteen patients underwent surgery between March 1, 2020 and April 9, 2020. Operative diagnosis and procedure; droplet count and distribution on face shields were documented. Results Forty‐five surgical procedures were performed for neck nodal metastatic carcinoma of unknown origin (n = 3); carcinoma of tonsil (n = 2), tongue (n = 2), nasopharynx (n = 3), maxilla (n = 1), and laryngopharynx (n = 4). Droplet contamination was 57.8%, 59.5%, 8.0%, and 0% for operating, first and second assistant surgeons, and scrub nurse respectively. Droplet count was highest and most widespread during osteotomies. No droplet splash was noted for transoral robotic surgery. Conclusion Face shield is not a mandatory adjunctive PPE for all head and neck surgical procedures and health care providers. Judicious use helps to conserve resources during such difficult times.