Shyr Bor-Uei, Yeh Yi-Ting, Teng Wei-Nung, Liu Chin-Su, Chen Paul Chih-Hsueh, Huang Ling-Ju, Tseng Ling-Ming, Ma Hsu
Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
Department of Surgery, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Plast Reconstr Surg Glob Open. 2023 Jan 18;11(1):e4792. doi: 10.1097/GOX.0000000000004792. eCollection 2023 Jan.
In the era of the coronavirus disease 2019 (COVID-19) pandemic, surgeons and medical staff are often at a high risk of infection in the operating room, especially when the patient is spontaneously breathing. In this study, we examined the minimum requirements for personal protective equipment with double surgical masks to potentially reduce unnecessary waste of supplies.
Two mannequins were each connected to a test lung machine simulating a surgeon and patient with spontaneous breathing. An aerosol generator containing severe acute respiratory syndrome coronavirus 2 virion particle substitutes was connected to the patient mannequin. The sampling points for the target molecules were set at different distances from the patient mannequin and sent for multiplex quantitative polymerase chain reaction analysis. Three clinical scenarios were designed, which differed in terms of the operating room pressure and whether a fabric curtain barrier was installed between the mannequins.
Analysis of the multiplex quantitative polymerase chain reaction results showed that the cycle threshold (Ct) value of the target molecule increased as the distance from the aerosol source increased. In the negative-pressure operating room, the Ct values were significantly increased at all sample points compared with the normal pressure room setting. The Ct value sampled at the surgeon mannequin wearing double face masks was significantly increased when a cloth curtain barrier was set up between the two mannequins.
Double surgical masks provide elementary surgeon protection against COVID-19 in a negative pressure operating room, with a physical barrier in place between the surgeon and patient who is spontaneously breathing during local anesthesia or sedated surgery.
在2019冠状病毒病（COVID - 19）大流行时代，外科医生和医护人员在手术室常面临高感染风险，尤其是当患者自主呼吸时。在本研究中，我们研究了使用双层外科口罩作为个人防护装备的最低要求，以潜在减少物资的不必要浪费。
两个人体模型分别连接到模拟外科医生和自主呼吸患者的测试肺机器。一个装有严重急性呼吸综合征冠状病毒2病毒粒子替代物的气溶胶发生器连接到患者人体模型。目标分子的采样点设置在距患者人体模型不同距离处，并送去进行多重定量聚合酶链反应分析。设计了三种临床场景，它们在手术室压力以及人体模型之间是否安装织物窗帘屏障方面有所不同。
多重定量聚合酶链反应结果分析表明，目标分子的循环阈值（Ct）值随着距气溶胶源距离的增加而增加。在负压手术室中，与常压房间设置相比，所有采样点的Ct值均显著增加。当在两个人体模型之间设置布帘屏障时，佩戴双层口罩的外科医生人体模型处采样的Ct值显著增加。
在负压手术室中，双层外科口罩为外科医生提供了针对COVID - 19的基本防护，在局部麻醉或镇静手术期间，外科医生与自主呼吸的患者之间设有物理屏障。
