Does a surgical helmet provide protection against aerosol transmitted disease?

Background and purpose - The COVID-19 pandemic caused by infection with SARS-CoV-2 has led to a global shortage of personal protective equipment (PPE). Various alternatives to ordinary PPE have been suggested to reduce transmission, which is primarily through droplets and aerosols. For many years orthopedic surgeons have been using surgical helmets as personal protection against blood-borne pathogens during arthroplasty surgery. We have investigated the possibility of using the Stryker Flyte surgical helmet as a respiratory protective device against airborne- and droplet-transmitted disease, since the helmet shares many features with powered air-purifying respirators.Materials and methods - Using an aerosol particle generator, we determined the filtration capacity of the Stryker Flyte helmet by placing particle counters measuring the concentrations of 0.3, 0.5, and 5 µm particles inside and outside of the helmet.Results - We found that the helmet has insufficient capacity for filtrating aerosol particles, and, for 0.3 µm sized particles, we even recorded an accumulation of particles inside the helmet.Interpretation - We conclude that the Stryker Flyte surgical helmet should not be used as a respiratory protective device when there is a risk for exposure to aerosol containing SARS-CoV-2, the virus causing COVID-19, in accordance with the recommendation from the manufacturer.

Surgical helmets can be converted into efficient disinfectable powered air-purifying respirators.

BACKGROUND: Filtering facepiece respirators often fail to provide sufficient protection due to a poor fit. Powered air-purifying respirators (PAPRs) are not designed for healthcare personnel, and are challenging to disinfect. Surgical helmets (SH) are available in many United States hospitals but do not provide respiratory protection. Several modifications to SH have been suggested, but none are sufficiently compliant with safety and efficiency standards. The purpose of this investigation was the development of a filter adaptor, which converts SHs into efficient, safe, and disinfectable PAPRs. METHODS: Four critical features were investigated close to regulatory requirements: total inward leakage of particles, CO2 concentrations, intra-helmet differential pressure, and automated disinfection. RESULTS: The average total inward leakage in the 2 independent tests were 0.005% and 0.01%. CO2 concentrations were lower than in the original SH. The modification generates a positive differential pressure. The filter's performance was not compromised after 50 cycles in a sterilization machine. DISCUSSION: The modified SH provides several hundred times better protection than FFP-3 masks. CONCLUSIONS: Surgical helmets can be modified into safe, efficient, and disinfectable PAPRs, suitable for HCP and the operating room in particular. They can play a role in the preparedness for upcoming events requiring efficient respiratory protection.

Intra-Articular Osteotomy of the Distal Radius with the Use of Inexpensive In-House 3D Printed Surgical Guides and Arthroscopy: A Case Report.

CASE: An 18-year-old man complained about persistent wrist pain and functional impairment due to intra-articular malunion, 1 year after volar plating of a distal radius fracture. We designed and produced patient-specific surgical guides (PSSGs) in-house with a benchtop three-dimensional printer to perform an arthroscopy-assisted intra-articular osteotomy of the radial column without dorsal arthrotomy. The procedure was performed without complications. After 1 year, there was no osteoarthritis and the patient's wrist function was practically normalized. CONCLUSIONS: Virtual surgical planning, design, and production of PSSGs were feasible without consultation of an external medical engineering company and without dorsal arthrotomy.