'Polidon' Approach - A Novel Approach of Mastoidectomy in COVID-19 Pandemic

Abstract

Background: WHO declared COVID-19 outbreak as pandemic in March, 2020, which was started from Wuhan of china. Mastoidectomy is an aerosol generating procedure. If a patient of COVID-19, either confirmed, suspected or asymptomatic career, requires mastoidectomy urgently, it’s a critical issue for the health care professionals for the highly contagious nature of this novel corona virus. Here, some simple, but novel and very effective measures will be discussed for protection of all health care providers (HCPs). Polythene sheet and Povidone Iodine are the change makers in this novel approach of mastoidectomy, mentioned in this article. So, we named the technique as ‘POLIDON approach’ of mastoidectomy.

Method/ Material: Placement of a transparent, sterile polythene sheet which acts as an interface between patient and surgeons and all other OR staffs is an important issue. Meanwhile, extended use of Povidone Iodine (PVP-I) is recommended in different way. Mouthwash for gargling and nasal application either by spray or nasal irrigation or drop will reduce viral load from nose and mouth of patient. HCPs should use PVP-I prophylactically also. Thus the chance of transmissibility of novel coronavirus is reduced Meanwhile, Povidone Iodine should be mixed with irrigating fluid to help in reduction of contamination by bone dust mixed with fluid, produced during surgery.

Conclusion: As mastoidectomy is an aerosol generating procedure, and novel coronavirus is highly contagious, so higher level of protection is required. A simple and cheap polythene sheet as barrier drape as well as rational and novel use of Povidone Iodine, i.e. the proposed ‘POLIDON’ approach can significantly reduce the chance of corona virus transmission among the health care professionals working in the operation theatre.

Abbreviations: PVP-I- Povidone Iodine, HCP- Health care provider

Note: Conflict of Interest: All authors declared, there is no conflict of interest.

Funding: None to declare

Ethical Approval: Clearance certificate was acquired from the Ethical review committee of Dhaka Medical College.