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    Assessing the risk of viral infection from gases and plumes during intra-abdominal surgery: a systematic scoping review

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    Author
    Gavin, DJ; Wilkie, BD; Tay, J; Loveday, BPT; Furlong, T; Thomson, BNJ
    Date
    2020-08-17
    Source Title
    ANZ Journal of Surgery
    Publisher
    WILEY
    University of Melbourne Author/s
    Furlong, Tim; Thomson, Benjamin; Loveday, Benjamin
    Affiliation
    Surgery (RMH)
    University General
    Metadata
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    Document Type
    Journal Article
    Citations
    Gavin, D. J., Wilkie, B. D., Tay, J., Loveday, B. P. T., Furlong, T. & Thomson, B. N. J. (2020). Assessing the risk of viral infection from gases and plumes during intra-abdominal surgery: a systematic scoping review. ANZ JOURNAL OF SURGERY, 90 (10), pp.1857-1862. https://doi.org/10.1111/ans.16242.
    Access Status
    Access this item via the Open Access location
    URI
    http://hdl.handle.net/11343/254389
    DOI
    10.1111/ans.16242
    Open Access URL
    https://europepmc.org/articles/PMC7461014?pdf=render
    Abstract
    BACKGROUND: The aim of this study was to identify the current evidence regarding the risk of acquiring viral infections from gases or plumes during intra-abdominal surgery. Peritoneal fluids may contain cellular material and virus particles. Electrocautery smoke and plumes from energy devices may aerosolize harmful substances and viral particles. Insufflation and desufflation during laparoscopic surgery may also aerosolize and distribute biological material. A systematic scoping review was performed to assess the evidence and inform safe surgical practice. METHODS: A systematic search of the PubMed and Medline databases was undertaken until June 2020, observing Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology, to identify articles associating viral infection of operating room staff from surgical gases and plumes. All evidence levels were included. The search strategy utilized the search terms 'surgery', 'laparoscopy', 'laparoscopic' 'virus', 'smoke', 'risk', 'infection'. RESULTS: The literature search identified 74 articles. Eight articles relevant to the subject of this review were included in the analysis, two of which specifically related to intra-abdominal surgery. Of the remaining six, four involved gynaecological surgery and two were in-vitro studies. No evidence that intra-abdominal surgery was associated with an increased risk of acquiring viral infections from exsufflated gas or smoke plumes was identified. CONCLUSION: There is currently no evidence that respiratory viruses can be found in the peritoneal fluid. Whilst there is currently no evidence that desufflated carbon dioxide or surgical smoke plumes present a significant infectious risk, there is not a wealth of literature to inform current practice. Further clinical research in this area is required.

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