Personal Protective Equipment and COVID-19: A Review for Surgeons

Abstract

: There is a long history of personal protective equipment (PPE) used by the surgeon to minimize the transmission of various pathogens. In the context of the present coronavirus disease 2019 pandemic there is significant controversy as to what forms of PPE are appropriate or adequate. This review aims to describe the pathogenic mechanism and route of spread of the causative virus, severe acute respiratory syndrome coronavirus, as it pertains to accumulated published data from experienced centers globally. The various forms of PPE that are both available and appropriate are addressed. There are options in the form of eyewear, gloves, masks, respirators, and gowns. The logical and practical utilization of these should be data driven and evolve based on both experience and data. Last, situations specific to surgical populations are addressed. We aim to provide granular collective data that has thus far been published and that can be used as a reference for optimal PPE choices in the perioperative setting for surgical teams.

FIGURE 1

Schematic of droplet versus airborne transmission of respiratory particles produced from a cough. A coughing subject produces respiratory particles of various sizes; larger droplets tend to follow a ballistic trajectory (black lines), whereas aerosolized particles (gray dots) become suspended in air to varying degrees, extending their range.