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Comparison of aerosol generation between electrocautery and cold dissection tonsillectomy
E Sanmark1,2, N Rantanen3, L-M Oksanen1,2
1Faculty of Medicine, University of Helsinki, Finland.
The Journal of Laryngology and Otology
|March 27, 2023
Summary
Cold dissection generates significantly less aerosol during tonsillectomy than bipolar electrocautery. This finding is crucial for assessing airborne transmission risks during surgical procedures, especially during pandemics.
Area of Science:
- Otolaryngology
- Infectious Disease Epidemiology
- Surgical Safety
Background:
- Tonsillectomy aerosol generation is not well understood, posing risks during pandemics.
- Assessing surgical techniques for airborne particle production is critical for infection control.
Purpose of the Study:
- To quantify aerosol generation during tonsillectomy.
- To compare particle production across different surgical techniques and instruments.
- To inform risk assessment for airborne transmission during surgical procedures.
Main Methods:
- Optical particle sizer used to measure aerosol concentrations.
- Tonsillectomy procedures (n=18) analyzed for particle generation.
- Coughing and background operating theatre levels used as reference points.
Main Results:
- Bipolar electrocautery generated significantly higher aerosol concentrations (total and <1 μm particles) than cold dissection and BiZact.
- Bipolar electrocautery exceeded particle generation levels of coughing for surgeons.
- No technique exposed other staff to aerosol concentrations greater than coughing.
Conclusions:
- Cold dissection is a safer tonsillectomy technique regarding aerosol generation.
- Bipolar electrocautery produces high aerosol concentrations, posing a higher risk.
- Findings support cold dissection for reducing airborne transmission during tonsillectomy, especially during epidemics.
