Pediatric dentist attire and relationship with anxiety in children and parents during Covid-19 pandemic

Aim The study aimed to evaluate children's and parent's preferences of dentist's attire during Covid-19 pandemic and their relationship with dental anxiety. Methods A total of 139 Children(71 boys, 68 girls) aged 6-12 years were shown videos of a pediatric dentist working with different attire such as Personal Protective Equipment (PPE) and pedoscrub, and they were asked to express the way they preferred their dentist to be dressed. Children's anxiety levels with different attire of paediatric dentists were assessed in different age groups and for boys and girls separately and recorded it using the Facial image scale. A questionnaire regarding dental anxiety was created online and completed by 139 parents (76 females, 63 males) of various ages and different educational backgrounds who were asked to choose between two outfits. Results were tabulated and statistically analysed using Chi-square test. Results Children aged 10-12 years preferred PPE by 50.6%, whereas 48.1% of children aged 6-9 years least preferred PPE (<0.05). About 46 (33%) were scored as anxious children and they had a preference for pedoscrub. Also, nonanxious children 43(31%) preferred PPE. All educated parents (100%) selected PPE over pedoscrub and the result were shown to be statistically significant. (<0.05). Conclusion Ultimately, the majority of the anxious children chosen pedoscrub, whereas non - anxious children have chosen PPE. Furthermore, the data reveals that both educated parents and older children preferred PPE as their attire for paediatric dentists.

Paramentação cirúrgica: artigo de revisão / Surgical attire: a review article

Esta revisão objetivou a descrição da paramentação cirúrgica e suas reais necessidades. Procedimentos cirúrgicos e anestésicos tornam necessárias precauções para reduzir os riscos biológicos que ocorrem em pacientes e na equipe multiprofissional em contato com líquidos, tecidos orgânicos e agentes infecciosos em centro cirúrgico. Seu intuito é proteger pacientes e a equipe multiprofissional contra microrganismos presentes e liberados em centro cirúrgico. A paramentação cirúrgica é a troca das vestimentas rotineiras por outras adequadas, em áreas restritas ou semirrestritas do centro cirúrgico, proporcionando barreiras contra ainvasão de microrganismos. Utilizou-se a seleção de artigos publicados na MEDLINE, LILACS, PUBMED, COCHRANE LIBRARY e livros. Não existem normas de leis para o uso da paramentação cirúrgica, ficando sob a vigilância sanitária vigente em cada município e ainda às normas internas de funcionamento de cada centro cirúrgico. Constitui-se em medida eficaz na redução dos processos infecciosos pós-operatórios, mesmo com resultados contraditórios em vários estudos sobre o reconhecimento das reais fontes e formas de transmissão dos microrganismos em um centro cirúrgico.

This review focused on the description of surgical attire and its actual requisite use. Surgical and anesthetic procedures requite that precautions are taken to reduce biological risk to patients and to the multiprofessional team in contact with fluids, organic tissues and infectious agents in the surgical center. Its purpose is protecting patients and the multiprofessional team against microorganisms existing and released in the surgical center. Use of surgical attire includes the exchange of everyday clothing for more adequate pieces in restricted or semi-restricted areas in the operatingroom, thus providing barriers against the invasion of microorganisms. A selection of articles published in MEDLINE, LILACS, PUBMED, COCHRANE LIBRARY and books were used. There are no regulations in place for the use of surgical attire, and its use is controlled by each municipaltiy's health surveillance team as well as by internal rules of operation in every surgical center. It constitutes an effective measure to decrease postoperative infectious processes, even though several studies contradict with regards to the actual sources and modes of transmission of microorganisms in the operating room.

Barreira microbiana das máscaras cirúrgicas descartáveis segundo o seu tempo de utilização / Microbial barrier of disposable masks in relation to their usage time

A prática da utilização de máscaras cirúrgicas durante a realização dos procedimentos cirúrgicos, como uma medida de prevenção da infecção do sítio cirúrgico (ISC), vem sendo questionada nos últimos tempos. Com o intuito de produzir evidências científicas, foi desenvolvida a presente investigação, com delineamento experimental, controlado, que teve como objetivo avaliar a eficácia da barreira microbiana das máscaras cirúrgicas descartáveis (Eficácia de Filtração Bacteriana - BFE- de 95%), segundo o seu tempo de utilização (1 hora, 2 horas, 4 horas e 6 horas). Os dados foram coletados em uma sala de operação de uma unidade de centro cirúrgico de um hospital privado do município de São Paulo cuja estrutura física atende às recomendações atuais propostas pelo Ministério da Saúde (RDC-50 - MS/2002). Para os experimentos, constituíram-se 2 grupos denominados controle e experimental. O primeiro sem utilização de máscaras cirúrgicas e o segundo com elas. A fim de reproduzir as conversações que normalmente ocorrem entre a equipe cirúrgica durante o ato operatório, uma variável que interfere no período de validade das máscaras cirúrgicas descartáveis, manteve-se o controle de palavras emitidas pelos colaboradores da coleta de dados, nos dois grupos, em todos os tempos estudados. Para controlar a influência do ambiente, foram mantidas placas de Petri no ambiente de sala de operações, próximas à entrada do ar condicionado. Realizou-se a contagem das Unidades Formadoras de Colônia (UFC) das unidades de análise das simulações em ambos os grupos, nos intervalos de tempo pré-estabelecidos (1, 2, 4 e 6 horas), por meio das placas de Petri com meio de cultura (Agar Triptona Soja -ATS) dispostas sobre a mesa cirúrgica. Foram identificados os microrganismos mais freqüentes encontrados nas simulações. Os dados foram submetidos à análise estatística e os resultados mostraram que a utilização da máscara cirúrgica diminuiu ) diminuiu (coeficiente de regressão = -20,10) a média de UFC das placas da mesa cirúrgica que simulou o campo operatório, em todos os tempos testados. Verificou-se que a sua utilização além de 2 horas aumentou a contaminação das placas da mesa cirúrgica. Nas análises estatísticas foram consideradas as interferências da contaminação ambiental e constatou-se que existiu uma correlação positiva alta (coeficiente de correlação = 0,886) entre as médias de UFC da mesa cirúrgica e do ambiente, estatisticamente significante (P< 0,001). Concluiu-se que as máscaras cirúrgicas descartáveis (BFE 95%) demonstraram constituir barreiras microbianas eficazes em todos os tempos estudados, diminuindo sua eficácia de filtração após 2 horas de sua utilização

The practice of the use of surgical masks during surgical procedures as a preventive measure against Infection of the Surgical Site (ISS) has been questioned lately. With the aim of producing scientific evidence, the present investigation was developed - with an experimental controlled basis - in order to evaluate the effectiveness of microbial barriers of disposable surgical masks (Bacterial Filtration Effectiveness - BFE - 95%) in relation to their usage time (one, two, four and six hours). Data were collected inside an operating room of the operation theatre unit of a private hospital in the city of São Paulo, whose physical structure meets the recommendations currently proposed by the Health Ministry (RDC - 50 - MS/2002). Two groups were formed for the carrying out of these experiments, respectively denominated control group and experimental group: in the first group no surgical masks were used; in the second surgical masks were used. In order to reproduce conversations that usually take place among the surgical team members during surgeries - a variable which interferes in the validity period of disposable surgical masks - control was kept of words uttered by those collaborating in the gathering of the data, in the two groups, for all the times studied. In order to control the influence of the environment, Petri dishes were maintained in the operating room environment, close to the air conditioning inlets. A count was taken of the Colony Forming Units (CFU) of the units of simulation analysis in both groups, at pre-established time intervals (1,2,4 and 6 hours), through Petri dishes with culture medium (Agar Trypton Soybean - ATS) placed on the surgical table. Identification was made of the most frequent micro organisms found in the simulations; these data were submitted to statistical analysis and the results demonstrated that the use of surgical masks decreased (regression coefficient = -20,10) the the average count of CFU in the Petri dishes placed on the surgical table which simulated the surgical field in all of the times tested. It was verified that their use beyond 2 hours increased contamination of the dishes placed on the surgical table. In the statistical analyses, the interferences of milieu contamination were considered and it was found that there was a high positive correlation (correlation coefficient = 0,886) between the average count of CFU in the surgical table and in the environment, which was statistically significant (P<0,001). The final conclusion was that disposable surgical masks (BFE 95%) proved to be effective microbial barriers in all of the times studied. Their BFE decreased after two hours of use