Is the use of a powered dermatome an aerosol-generating procedure (AGP)? Implications for personal protection against COVID-19 virus.
Published Date: 04th May 2022
Publication Authors: Kyriazidis I, Shokrollahi K, Zack-Williams SDL, Jones C, Murgatroyd E, Gurusinghe D
Poster presentation for the BBA Annual Meeting, May 2022. Full conference programme available here: https://www.britishburnassociation.org/wp-content/uploads/2018/04/BBA-Bristol-4-6.5.22-Full-Programme-.pdf
Introduction
Many healthcare workers have contracted SARS-CoV-2 during the pandemic, many cases of which have resulted in severe illness and death. No studies have assessed the potential for powered dermatomes to generate aerosol, an essential technique in burns and plastic surgery. The primary aim of the present study was to capture video footage to illustrate the potential for a powered dermatome to generate significant spray and hence aerosol.
Method
We utilised a simulated skin graft harvest experimental method. Fluorescein-stained saline was used with ultraviolet (UV) backlighting to demonstrate fluorescent spray from a popular brand of air-powered dermatome. Ultra-slow-motion (960 frames/s) video was used to demonstrate the oscillation of the dermatome blade and the origin within the machine of any spray generated, and the extent of spray generated
Results
Ultra-slow-motion video at 960 FPS was captured during usage of a powered dermatome. Droplets of various sizes spraying out from the leading edge at the sides where the blade oscillates are clearly visible. The spray emerges from the leading edge of the dermatome back- wards at an approximate angle of 45°.
Our study demonstrates that powered dermatome usage is likely to generate aerosol from blood or blood-contaminated fluid, but does not demonstrate or quantify to what extent this may be clinically relevant in terms of viral transmission potential. We suggest ways to reduce the risk of spray from dermatomes including limiting donor-site bleeding and avoiding a wet donor area.
Kyriazidis, I; Shokrollahi, K; Zak-Williams, S; Jones, C; Murgatroyd, E; Gurusinghe, D. (2022). Is the use of a powered dermatome an aerosol-generating procedure (AGP)? Implications for personal protection against COVID-19 virus. Conference poster from British Burns Association Annual Meeting, 4th-6th May 2022.
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