Cost-Effective Microscopic Draping: COVID-19 Umbrella

Abstract

We describe a cost-effective solution to limit aerosol transmission to the surgeon and other personnel in the operating room during otologic surgery.

Concerns about droplets and virus aerosolization have been raised ¹ particularly after confirmation of SARS-CoV-2 colonization of the middle ear and mastoid by Frazier and colleagues in 2 of 3 postmortem dissections. ² During the mastoid drilling, a large cloud of irrigation and bone dust created by performing mastoidectomy can be easily inhaled. Sufficient data were published for the safety of surgical procedures in the setting of the coronavirus disease 2019 (COVID-19) pandemic.^3,4

We described a cost-effective solution to limit aerosol transmission to the surgeon and other personnel in the operating room. The microscope used during mastoid bone drilling is routinely covered with a sterile, clear drape. The simple surgical chair cover was used to cover the area between the microscope and the surgical field. The chair drape (Figure 1; Genesys, Ecolab Banded Nag with Rubber Band and Tape) was cut on the bottom and then attached to the microscope drape using the built-in rubber band (Figure 2). The other end is then draped around the operative field (Figure 3).

Figure 1.

The simple surgical chair cover was used to cover the area between the microscope and the surgical field.

Figure 2.

The chair drape (Genesys, Ecolab Banded Nag with Rubber Band and Tape) was cut on the bottom and then attached to the microscope drape using the built-in rubber band.

Figure 3.

Described method neither restricts hand movement nor restricts visualization and still offers additional protection from bone dust during any otologic procedure.

Described methods neither restrict hand movement significantly (Figure 3) nor require any additional training and still offer additional protection from the aerosol spread in the vicinity of the provider during any otologic procedure.

We would like to highlight the cost-effective nature of this technique specifically. In our institution, the price per each surgical armchair cover is US$1.15/each, as compared to the price for one microscope drape of US$30.28/each, or C-Armor drape of US$41.82/each and Steri-Drape 1015 of US$2.72/each. These prices show a more cost-effective method as compared to what has been described previously, especially with custom-made drapes as described in the literature.^5-7 Proper use of personal protective equipment and antiviral filters in close proximity to the patient is strongly recommended for safety.