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Deprecated: Implicit conversion from float 286.79999999999995 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 World+Neurosurg 2021 ; 150 (ä): 153-160 Nephropedia Template TP
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Negative Pressure Assisted Microenvironment Surgical Hood: A Novel Cost-Effective Device to Minimize Aerosol Contamination During Neurosurgical Procedures in Times of COVID-19 #MMPMID33746105
Patir R; Sreenivasan SA; Vaishya S
World Neurosurg 2021[Jun]; 150 (ä): 153-160 PMID33746105show ga
OBJECTIVE: Present guidelines on reducing aerosol generation during neurosurgical procedures are futile. The aim of this article was to describe a novel device to contain aerosol within a small localized environment around the operative field-the negative pressure assisted microenvironment surgical hood (NEPA-MESH). METHODS: This device can be assembled using easily available materials-steel wires, image intensifier cover, surgical drape, and three-dimensional-printed self-locking copolyester double hoops. Large-bore pipes in continuity with a high-volume suction apparatus create a constant negative pressure microenvironment around the operative field. The CEM DT-9880 particle counter was used to estimate particle concentration inside the NEPA-MESH during various stages of a neurosurgical procedure as well as outside. The NEPA-MESH was tested in different craniotomies and endoscopic procedures. RESULTS: Mean particle concentration inside the NEPA-MESH and outside during drilling in various procedures was calculated and compared using unpaired t test. Significant reduction in particle concentrations was recorded for particles sized 0.3 mum (t = 17.55, P < 0.0001), 0.5 mum (t = 11.39, P < 0.0001), 1 mum (t = 6.36, P = 0.0002), 2.5 mum (t = 2.04, P = 0.074), 5.0 mum (t = 7.026, P = 0.0008), and 10 mum (t = 4.39, P = 0.0023). CONCLUSIONS: As definitive evidence demonstrating the presence of coronavirus disease 2019 (COVID-19) in aerosol particles is awaited, we describe a cost-effective strategy to reduce aerosol contamination. Significant reduction in particle concentrations was seen outside the NEPA-MESH compared with inside it during various stages of neurosurgical procedures.