Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is not detected in the aerosol plume generated from electrocautery, according to a research letter published online May 21 in JAMA Surgery.

Noting that direct transmission of aerosolized SARS-CoV-2 in an electrocautery plume to surgical staff has been raised as a safety concern, Leigh J. Sowerby, M.D., from the University of Western Ontario in London, Canada, and colleagues examined whether tip temperatures, which range from 100 to 1,200 degrees Celsius, could inactivate SARS-CoV-2 in the plume. Electrocautery at 25 W was applied using three methods for one minute on raw chicken breast containing SARS-CoV-2 at an infectious dose similar to the viral load in the pulmonary sputum of a patient with symptoms. Liquid was vaporized during electrocautery and was collected onto a gelatin filter. About 0.3 mL of both viral media and blood with SARS-CoV-2 were aerosolized and collected in the same manner for a positive control.

The researchers observed no virus recovered from any electrocautery performed using a cell titer glow measurement for replicating virus. A recovery at least 3 or 4 base 10 logs higher than electrocautery or the negative control resulted from the aerosolized blood or media containing SARS-CoV-2. On the gelatin filter, the maximum theoretical recovery of SARS-CoV-2 was about 1 x 10^6.2 units. In the absence of cautery, viral RNA was readily detected in the control aerosols of both fluids.

"Future work investigating the plume associated with lower-temperature thermal surgery (such as coblation or carbon dioxide laser) and different tissue substrates is warranted," the authors write.

Two authors disclosed financial ties to Sanofi, GlaxoSmithKline, and/or Medtronic.

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