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Quantifying Aerosol Generation in Maxillofacial Trauma Repair Techniques.

Adam McCann1, Kyle Singerman1, James Coxe1

  • 1Department of Otolaryngology - Head and Neck Surgery, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.

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Summary

Particle generation during maxillofacial surgery is reduced at greater distances. Using self-drilling screws significantly lowers particle concentration compared to power drilling, enhancing operating room safety against airborne diseases like COVID-19.

Keywords:
COVID-19aerosolizationmaxillofacial traumaopen reduction internal fixationparticle concentration

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Infectious Disease Control
  • Surgical Aerosol Generation

Background:

  • Healthcare workers face risks from aerosolized particles during procedures like maxillofacial trauma repair.
  • Protecting surgical teams from airborne diseases, such as COVID-19, is critical during intraoperative settings.

Purpose of the Study:

  • To evaluate particle generation during open reduction and internal fixation (ORIF) of maxillofacial injuries.
  • To assess the impact of distance and drilling technique on intraoperative aerosol concentration.

Main Methods:

  • A cadaveric simulation study was conducted using simulated operating room conditions.
  • Open reduction and internal fixation (ORIF) of midface and mandible fractures were performed using intraoral incisions.
  • Particle concentration was measured at 0.45m, 1.68m, and 3.81m from the operative site during procedures with both self-drilling screws and power drilling.

Main Results:

  • Particle concentration significantly decreased at 1.68m compared to 0.45m.
  • A further significant decrease in particle concentration was observed between 1.68m and 3.81m in some procedures.
  • Self-drilling techniques generated significantly less particle concentration than power drilling at all measured distances.

Conclusions:

  • Maintaining physical distancing protocols in the operating room can reduce airborne disease transmission risk.
  • Employing self-drilling screwing techniques during ORIF may further mitigate the risk of intraoperative aerosol exposure.