ABSTRACT
Background: Sawing of bone is an essential part of an autopsy procedure. An oscillating saw always generates noise, fine infectious dust particles, and the possibility of traumatic injuries, all of which can induce occupational hazard risks to autopsy workers, especially during the COVID-19 pandemic. Objectives: The first goal of this study was to explore the production of noise and bone dust emission, comparing an oscillating saw and a robotic autopsy saw during an autopsy. The second goal was to evaluate the performance of a new robotic autopsy method, used during skull opening. The third goal was to encourage mortuary workers to use robotic technology during the autopsy procedure to protect us away from occupational injuries as well as airborne infections. Materials and Methods: The experiments involved a comparison of noise levels and aerosol production during skull cutting between the oscillating saw and the robotic autopsy saw. Results: The results confirmed that noise production from the robotic autopsy saw was lower than the oscillating saw. However, the bone dust levels, produced by the robotic autopsy saw, were greater than the oscillating saw, but were not greater than the dust concentrations which were present before opening the skull. Conclusions: The use of a new robotic system might be an alternative choice for protecting against occupational damage among the healthcare workers. Further research might attempt to consider other healthcare problems which occur in the autopsy workplace and apply the robotic-assisted technology in autopsy surgery.
ABSTRACT
OBJECTIVES: Craniotomies/craniostomies have been categorized as aerosol-generating procedures and are presumed to spread coronavirus disease 2019 (COVID-19). However, the presence of severe acute respiratory distress syndrome coronavirus 2 virus in the generated bone dust has never been proved. Our objective is to evaluate the presence of virus in the bone dust (aerosol) generated during emergency neurosurgical procedures performed on patients with active COVID-19. This would determine the true risk of disease transmission during the surgery. METHODS: Ten patients with active COVID-19 infection admitted to our institute in 1 month required emergency craniotomy/craniostomy. The bone dust and mucosal scrapings form paranasal sinuses (if opened) collected during these procedures were tested for the virus using reverse transcription polymerase chain reaction. The entire surgical team was observed for any symptoms related to COVID-19 for 14 days following surgery. RESULTS: Nine patients had moderate viral load in their nasopharyngeal cavity, as detected on reverse transcription polymerase chain reaction. None of the samples of bone dust from these 10 patients tested positive. Mucosal scrapping obtained in 1 patient in which mastoid air cells were inadvertently opened tested negative as well. No health workers from the operating room developed COVID-19-related symptoms. CONCLUSIONS: The bone dust generated during craniotomy/stomy of active patients does not contain the virus. The procedure on an active patient is unlikely to spread the disease. However, a study with larger cohort would be confirmatory.