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)