PPE for surgery of the neck without airway or mucosal exposure
Although surgical procedures including cold steel incision and
dissection, suction, and cautery can theoretically aerosolize blood and
tissue particles27, the potential for SARS-CoV2 virus
aerosolization appears to be minimal outside the setting of the upper
aerodigestive tract. In fact, COVID-positive patients demonstrated no
detectable serum SARS-CoV2 RNA, compared to sputum analysis which
produced 7 x 106 – 2.35 x 109copies/ml 28. Therefore, the extant literature
suggests that standard surgical precautions are sufficient for surgery
involving the neck without mucosal membrane exposure in COVID-positive
patients. Accordingly, it may be recommended that providers exposed to
the surgical field (surgeons, surgical assistants, and surgical
technologists) wear standard PPE for surgeries (e.g. neck dissections)
without airway or mucosal exposure (i.e. loose-fitting surgical mask,
gloves, eye shield, and surgical gowns). (Table 1)