COVID-19 大流行期间儿科鼻腔和咽部手术中聚维酮碘消毒的注意事项。
Considerations for povidone-iodine antisepsis in pediatric nasal and pharyngeal surgery during the COVID-19 pandemic.
机构信息
Department of Otolaryngology-Head & Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, 75207, USA; Children's Medical Center Dallas, Dallas, TX, 75235, USA.
Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Department of Otorhinolaryngology - Head and Neck Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.
出版信息
Am J Otolaryngol. 2020 Nov-Dec;41(6):102737. doi: 10.1016/j.amjoto.2020.102737. Epub 2020 Sep 19.
PURPOSE
Surgeons resuming elective procedures during the COVID-19 pandemic should consider strategies to mitigate risk of exposure. For otolaryngologists performing surgery on children, unique vulnerability to SARS-CoV-2 results from a regular interface with the upper respiratory tract mucosa. A growing interest in perioperative application of povidone‑iodine (PVP-I) to the nasopharynx and oropharynx has emerged. The purpose of this review is to provide an evidence-based assessment of PVP-I in pediatric oral, nasal and pharyngeal surgery.
METHODS
A contemporary literature review with algorithmic approach to the potential use of PVP-I in pediatric mucosal surgery.
RESULTS
Several formulations of PVP-I have shown rapid in vitro virucidal activity against SARS-CoV-2. Antisepsis using 1.0% PVP-I mouthwash and 0.45% PVP-I throat spray can occur after 30 seconds of contact time. To date, in vivo effectiveness of PVP-I against SARS-CoV-2 has yet to be established and possible risks of its direct use on upper aerodigestive mucosa of children must be weighed.
CONCLUSION
Further research is required prior to strongly recommending PVP-I use in preparation for nasal, oral or pharyngeal surgery in children.
目的
在 COVID-19 大流行期间恢复择期手术的外科医生应考虑采取策略来降低暴露风险。对于为儿童施行手术的耳鼻喉科医生来说，由于经常接触上呼吸道黏膜，他们对 SARS-CoV-2 具有独特的易感性。人们对围手术期将聚维酮碘（PVP-I）应用于鼻咽和口咽的兴趣日益浓厚。本综述的目的在于为儿科口腔、鼻腔和咽部手术中 PVP-I 的应用提供基于证据的评估。
方法
采用现代文献回顾和算法方法，对 PVP-I 在儿科黏膜手术中的潜在应用进行评估。
结果
几种 PVP-I 制剂已显示出对 SARS-CoV-2 的快速体外病毒杀灭活性。使用 1.0% PVP-I 漱口水和 0.45% PVP-I 喉喷雾剂进行消毒，接触 30 秒后即可起效。迄今为止，PVP-I 对 SARS-CoV-2 的体内有效性尚未得到证实，必须权衡其直接用于儿童上呼吸道黏膜的可能风险。
结论
在强烈建议将 PVP-I 用于准备儿童的鼻腔、口腔或咽部手术之前，还需要开展更多的研究。
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