Guidance on infection control and plume management with Laser and Energy-Based Devices taking into consideration COVID-19.


Journal

The Australasian journal of dermatology
ISSN: 1440-0960
Titre abrégé: Australas J Dermatol
Pays: Australia
ID NLM: 0135232

Informations de publication

Date de publication:
Feb 2021
Historique:
received: 26 05 2020
revised: 18 06 2020
accepted: 05 07 2020
pubmed: 21 8 2020
medline: 26 2 2021
entrez: 21 8 2020
Statut: ppublish

Résumé

The COVID-19 pandemic has disrupted the practice of medicine. Dermatologic laser and energy-based device (EBD) treatments carry a potential risk for the transmission of SARS-CoV-2 both for the patient and the practitioner. These risks include close practitioner to patient proximity, the treatment of higher viral load areas such as the face, the potential for infective bioparticles being carried by generated plumes and aerosols, and the direct contact between device, practitioner and patient. SARS-CoV-2 is a highly infective respiratory pathogen transmitted by respiratory droplets, respiratory/mucosal secretions, medically generated aerosols and via its transfer from contaminated fomites. This requires a review of the appropriateness of infection control protocols in regard to dermatologic laser and energy-based device treatments. A critical evaluation of patient skin preparation including skin asepsis, device disinfection, laser and electrosurgical plume management and PPE in regard to SARS-CoV-2 was performed. The adherence to a high standard of skin preparation and asepsis, device disinfection, laser and electrosurgical plume and aerosol management and appropriate PPE should help mitigate or reduce some of the inherent treatment risks. Head and neck treatments along with aerosol and laser plume generating treatments likely carry greater risk. COVID-19 needs to be considered in the clinic set-up along with the planning, treatment and post-treatment care of patients utilising EBD procedures. Some of these treatment precautions are COVID-19 specific; however, most represent adherence to good infectious disease and established laser and EBD safety precautions.

Sections du résumé

BACKGROUND BACKGROUND
The COVID-19 pandemic has disrupted the practice of medicine. Dermatologic laser and energy-based device (EBD) treatments carry a potential risk for the transmission of SARS-CoV-2 both for the patient and the practitioner. These risks include close practitioner to patient proximity, the treatment of higher viral load areas such as the face, the potential for infective bioparticles being carried by generated plumes and aerosols, and the direct contact between device, practitioner and patient.
OBJECTIVES OBJECTIVE
SARS-CoV-2 is a highly infective respiratory pathogen transmitted by respiratory droplets, respiratory/mucosal secretions, medically generated aerosols and via its transfer from contaminated fomites. This requires a review of the appropriateness of infection control protocols in regard to dermatologic laser and energy-based device treatments.
METHODS METHODS
A critical evaluation of patient skin preparation including skin asepsis, device disinfection, laser and electrosurgical plume management and PPE in regard to SARS-CoV-2 was performed.
RESULTS RESULTS
The adherence to a high standard of skin preparation and asepsis, device disinfection, laser and electrosurgical plume and aerosol management and appropriate PPE should help mitigate or reduce some of the inherent treatment risks. Head and neck treatments along with aerosol and laser plume generating treatments likely carry greater risk.
CONCLUSIONS CONCLUSIONS
COVID-19 needs to be considered in the clinic set-up along with the planning, treatment and post-treatment care of patients utilising EBD procedures. Some of these treatment precautions are COVID-19 specific; however, most represent adherence to good infectious disease and established laser and EBD safety precautions.

Identifiants

pubmed: 32815148
doi: 10.1111/ajd.13425
pmc: PMC7461075
doi:

Substances chimiques

Aerosols 0

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

37-40

Informations de copyright

© 2020 The Australasian College of Dermatologists.

Références

J Clin Aesthet Dermatol. 2011 Feb;4(2):56-7
pubmed: 21386959
Ann Intern Med. 2020 Jun 2;172(11):766-767
pubmed: 32176257
Surg Endosc. 2003 Jun;17(6):979-87
pubmed: 12640543
Nature. 2020 Jun;582(7813):557-560
pubmed: 32340022
Surg Endosc. 2013 Sep;27(9):3100-7
pubmed: 23605191
Sci Adv. 2020 Nov 4;6(45):
pubmed: 33148655
J Hosp Infect. 2020 Mar;104(3):246-251
pubmed: 32035997
Eur Respir Rev. 2020 Apr 3;29(155):
pubmed: 32248146
Lancet Microbe. 2020 May;1(1):e10
pubmed: 32835322
Nat Med. 2020 May;26(5):672-675
pubmed: 32296168
N Engl J Med. 2020 Apr 16;382(16):1564-1567
pubmed: 32182409
J Hosp Infect. 2020 May;105(1):100-101
pubmed: 32147406
N Engl J Med. 2020 Mar 5;382(10):970-971
pubmed: 32003551
Appl Environ Microbiol. 2007 Mar;73(6):1687-96
pubmed: 17220247
JAMA. 2020 Apr 7;323(13):1239-1242
pubmed: 32091533
Nature. 2020 Mar;579(7798):270-273
pubmed: 32015507

Auteurs

John R Sullivan (JR)

The Sutherland Hospital, Caringbah, Australia.
University of New South Wales, Sydney, New South Wales, Australia.

Marius Rademaker (M)

Waikato Clinical Campus, University of Auckland's Faculty of Medical and Health Sciences, Hamilton, New Zealand.

Greg Goodman (G)

Monash University, Clayton, Victoria, Australia.
University College of London, London, UK.

Philip Bekhor (P)

The Royal Children's Hospital, Victoria The University of Melbourne, Parkville, Victoria, Australia.

Firas Al-Niaimi (F)

Department of Surgery and Laser Unit, Guy's Hospital, London, UK.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH