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Inanimate surface contamination of SARS-CoV-2 during midfacial fracture repair in asymptomatic COVID-19 patients - 22/01/22

Doi : 10.1016/j.jormas.2022.01.006 
Poramate Pitak-Arnnop a, , Nattapong Sirintawat b, Chatpong Tangmanee c, Passanesh Sukphopetch d, Jean-Paul Meningaud e, 1, Andreas Neff a, 1
a Department of Oral and Maxillofacial Surgery, UKGM GmbH, Campus Marburg, Faculty of Medicine, University Hospital of Giessen and Marburg, Philipps-University of Marburg, Baldingerstr, Marburg 35043, Germany 
b Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand 
c Department of Statistics, Chulalongkorn Business School, Bangkok, Thailand 
d Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Thailand 
e Department of Plastic, Reconstructive, Aesthetic and Maxillofacial Surgery, AP-HP, Faculty of Medicine, Henri Mondor University Hospital, University Paris-Est Créteil Val de Marne (Paris XII), Créteil, France 

Corresponding author.

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Abstract

Purposes

To evaluate inanimate surface contamination of SARS-CoV-2 during midfacial fracture repair (MFR) and to identify relevant aggregating factors.

Methods

Using a prospective non-randomised comparative study design, we enrolled a cohort of asymptomatic COVID-19 patients undergoing MFR. The predictor variables were osteofixation system (conventional titanium plates [CTiP] vs. ultrasound-assisted resorbable plates [USaRP]). The main outcomes were the presence of SARS-CoV-2 on four different surfaces. Other study variables were categorised into demographic, anatomical, and operative. Descriptive, bi- and multivariate statistics were computed.

Results

The sample consisted of 11 patients (27.3% females, 63.6% right side, 72.7% displaced fractures) with a mean age of 52.7 ± 20.1 years (range, 19–85). Viral spread was, on average, 1.9 ± 0.4 m. from the operative field, including most oral and orbital retractors’ tips (81.8% and 72.7%) and no virus was found at 3 m from the operative field, but no significant difference was found between 2 osteofixation types. On binary adjustments, significantly broader contamination was linked to centrolateral MFR (P = 0.034; 95% confidence interval [CI], 0.05 to 1.02), and displaced MFR > 45 min (P = 0.022; 95% CI, 0.1 to 1.03).

Conclusions

USaRP, albeit presumably heavily aerosol-producing, cause similar SARS-CoV-2 distribution to CTiP. Non-surgical operating room (OR) staff should stay ≥ 3 m from the operative field, if the patient is SARS-CoV-2-positive. Enoral and orbital instruments are a potential virus source, especially during displaced MFR > 45 min and/or centrolateral MFR, emphasising an importance of appropriate patient screening and OR organisation.

El texto completo de este artículo está disponible en PDF.

Keywords : SARS-CoV-2, COVID-19, Viral spread, Midfacial fracture, Facial trauma


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