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OBJECTIVE: To compare the degree of particle aerosolization with the use of several energy devices used in tonsillectomy and other common upper airway procedures. METHODS: Three different energy devices were measured. These included (a) monopolar electrocautery, (b) bipolar electrocautery, and (c) thermal welding device (TWD). Each device was applied to fresh cadaveric cow tongue and porcine nose. Aerosolized particles produced by these devices were measured using a calibrated electronic particle counter. Measurements were recorded over the course of 3 minutes. Particle sizes were measured at 0.3, 0.5, 1.0, 5, and 10 µm. RESULTS: In comparing types of tissues and particle sizes, TWD had the lowest aerosolizing burden among the three devices. By analyzing the highest particle value of TWD against both monopolar and bipolar, monopolar electrocautery proved to have the highest aerosolization exposure with statistical significance at 0.5 and 10 µm. No statistical significance was found when comparing TWD against monopolar electrocautery. DISCUSSION: Our study demonstrates there is a difference in aerosolization burden dependent on the type of device utilized. TWD proved to have the lowest burden whereas monopolar electrocautery had the highest. CONCLUSION: TWD produces less aerosolization than conventional monopolar electrocautery when cauterizing or ablating tissue in an experimental setting. The degree of aerosolization was comparable to bipolar electrocautery. LEVEL OF EVIDENCE: 2.
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OBJECTIVE: To determine a simplified method for nutritional status evaluation in surgical patients to identify patients prone to develop complications. METHODS: A prospective study was carried out to determine prognostic index of patients in whom major abdominal surgery was performed, based on nutritional assessment. We proposed a simplified and accessible method for daily evaluation of patients in any hospital even in an emergency setting. The following parameters were used: complete blood count (CBC); blood chemistry (BC); protrombine time (PT); total serum protein (TSP), and anthropometrics. RESULTS: Study population consisted of 200 patients divided in two groups depending on type of surgical intervention, i.e., emergency or elective procedure. Complications associated with different stages of malnourishment were analyzed by simplified nutritional assessment system. Of 200 patients analyzed, 123 had several stages of malnutrition, 62 were malnourished, complicated patients (50.41%), and 77 had adequate nutritional status; of these, 10 also had complications (12.99%). DISCUSSION: We were able to conclude that simplified nutritional assessment system is not a useful absolute predictive indicator of possible complications. However, some parameters could be useful to identify patients with nutritional depletion with tendency for post-surgical complications.
