Department of Obstetrics and Gynecology, Kansai Medical University, Osaka, Japan.
Department of Obstetrics and Gynecology, Kansai Medical University, Osaka, Japan.
J Hosp Infect. 2021 Nov;117:89-95. doi: 10.1016/j.jhin.2021.08.022. Epub 2021 Aug 27.
Gaseous by-products generated by surgical devices - collectively referred to as 'surgical smoke' - present the hazard of transmitting infective viruses from patients to surgical teams. However, insufficient evidence exists to evaluate and mitigate the risks of SARS-CoV-2 transmission via surgical smoke.
To demonstrate the existence and infectivity of human coronavirus RNA in surgical smoke using a model experiment and to evaluate the possibility of lowering transmission risk by filtration through a surgical mask.
Pelleted HeLa-ACE2-TMPRSS2 cells infected with human coronavirus were incised by electric scalpel and ultrasonic scalpel, separately. A vacuum system was used to obtain surgical smoke in the form of hydrosol. Reverse transcription-quantitative polymerase chain reaction was used to analyse samples for the presence of viral RNA, and infectivity was determined through plaque assay. Furthermore, a surgical mask was placed centrally in the vacuum line to evaluate its ability to filter viral RNA present in the surgical smoke.
In this model, 1/10 to 1/10 of the viral RNA contained in the incision target was detected in the collected surgical smoke. The virus present in the smoke was unable to induce plaque formation in cultured cells. In addition, filtration of surgical smoke through a surgical mask effectively reduced the amount of viral RNA by at least 99.80%.
This study demonstrated that surgical smoke may carry human coronavirus, though viral infectivity was considerably reduced. In clinical settings, surgical mask filtration should provide sufficient additional protection against potential coronavirus, including SARS-CoV-2, infection facilitated by surgical smoke.
手术器械产生的气态副产品——统称为“手术烟雾”——存在将感染性病毒从患者传播给手术团队的风险。然而，目前还没有足够的证据来评估和减轻通过手术烟雾传播 SARS-CoV-2 的风险。
通过模型实验证明手术烟雾中存在人类冠状病毒 RNA 及其感染性，并评估通过手术口罩过滤降低传播风险的可能性。
将感染了人类冠状病毒的 HeLa-ACE2-TMPRSS2 细胞沉淀用电刀和超声刀分别切割。使用真空系统以水溶胶的形式获得手术烟雾。通过逆转录定量聚合酶链反应分析样本中病毒 RNA 的存在情况，并通过噬斑试验确定其感染性。此外，将手术口罩放置在真空管路中央，以评估其过滤手术烟雾中存在的病毒 RNA 的能力。
在该模型中，在收集的手术烟雾中检测到了切割目标物中所含病毒 RNA 的 1/10 到 1/10。烟雾中的病毒无法在培养细胞中诱导噬斑形成。此外，手术口罩对手术烟雾的过滤至少使病毒 RNA 的量减少了 99.80%。
本研究表明，手术烟雾可能携带人类冠状病毒，尽管病毒感染性大大降低。在临床环境中，手术口罩过滤应该为包括 SARS-CoV-2 在内的潜在冠状病毒感染提供足够的额外保护，这是由手术烟雾引起的。
