Risk of COVID-19 transmission via electrocautery plume

Editor's Note

In this Canadian experimental study, SARS-CoV-2 was not detectable in aerosolized electrocautery plume generated from any of the conditions investigated.

The researchers mimicked surgery by applying electrocautery at 25 W using three different methods (monopolar cut, monopolar coagulate, and bipolar electrocautery) for 1 minute on raw chicken breast. Added to the chicken was 4 mL of viral media or blood mixture containing a median tissue culture infectious dose per mL of SARS-CoV-2, similar to the viral load in pulmonary sputum of a patient with symptoms. For a positive control, 0.3 mL of both viral media and blood with SARS-CoV-2 was aerosolized without heat.

No virus was recovered from any electrocautery methods performed, despite the high viral titers used. Viral RNA was readily detected in the control aerosols of both fluids in the absence of cautery.

The findings suggest that electrocautery smoke is an unlikely source of COVID-19 transmission for healthcare workers, the researchers concluded. Future studies investigating the plume associated with lower-temperature thermal surgery (such as coblation or carbon dioxide laser) and different tissue substrates are warranted, they say.