Pioneering infection control method during surgeries proves successful

INTERVIEW Pioneering infection control method during surgeries proves successful

This ENT specialist invented extra protection vs airborne diseases during surgical procedures.

SINGAPORE

Aerodrop Duo is an improved version of a mask (Photo: Dr. Chew Hui Sing, ENT Specialist, Tan Tock Seng Hospital)

When performing scope procedures, Dr. Chew Hui Sing, an ear, nose, throat (ENT) specialist from Tan Tock Seng Hospital (TTSH) in Singapore, found the dangers of aerosols or droplets from unmasked patients who are coughing and sneezing, which could lead to the spread of potentially infectious diseases.

Chew said they need an innovative tool to prevent the risk of infection transmission during procedures such as nasendoscopy.

“During this procedure, sometimes, despite the use of topical anaesthetic spray, patients may cough and sneeze. Coughing, sneezing, talking, or even breathing result in a significant amount of aerosols and droplets that are being released into the environment,” Chew told Healthcare Asia.

The ENT specialist thought of creating a tool to protect patients and healthcare workers during ENT procedures.

After consultation with the National Healthcare Group’s (NHG) Centre for Medical Technologies & Innovations (CMTi) and its industry partner, The Biofactory, Chew invented Aerodrop Duo, an environmentally-friendly dualfunction high-efficiency particulate (HEPA) filtration scope mask system. The BioFactory, a biomedical incubator in Singapore, is also the co-inventor of the device.

“We know that COVID-19 is not going to be the first nor the last pandemic in the history of human pandemics that we encounter,” said Chew.

“It is important that we take measures to bring about a safer method of performing such procedures, such that this service does not get disrupted in the next pandemic. It can also allow us to resume efficiently and safely without compromising the safety of healthcare workers or any patients or visitors,” she added.

Aerodrop Duo, as Chew pointed out, is a dual-function protective scope mask and filtration system. The mask is one-size-fits-all, transparent, hypoallergenic, has ports for scope access, and serves as a physical barrier itself. In addition, suction to the mask powered by the medical grade HEPA serves as a second layer of protection against any potential leakages from the mask edges.

The fully titratable HEPA filtration unit then serves as the third layer of protection to filter the ambient clinic air, even if there are no procedures performed. A HEPA filtration can trap tiny particles, according to John Hopkins University, a US-based research university.

“The idea is that of source control where we try to limit the contamination to the source itself before it even gets into the environment. This is a good idea because there are no other existing measures that will allow us to resume service as efficiently,” Chew.

Tested and tried

Before using the device in ENT procedures, Chew said they conducted experiments to determine whether the Aerodrop Duo can prevent aerosol and droplet contamination.

They conducted a pilot study of 15 healthy participants performing aerosol-generating activities with the Aerodrop Duo and compared it with a surgical mask and without a surgical mask.

The experiment showed that there is a slower particle emission rate for the Aerodrop Duo during breathing, speaking, and singing compared with other interventions (such as in masked or unmasked situations).

In conclusion, Chew’s team found that their innovative product is the first in the market to be connected to a portable HEPA filtration (of a minimum level of H13).

Fully reusable, eco-friendly

Data from the Ministry of Health in Singapore showed that the amount of biohazardous waste from hospitals and clinics generated and disposed of went up by 5% per annum from 2016 to 2020.

With this data in mind, the Aerodrop Duo developers wanted the device to be sustainable. They made parts of the medical device sterilisable, which reduces waste and carbon footprints.

Clinicians will also be more comfortable when performing scope procedures because they do not need to be in full personal protective equipment (PPE) or N95 masks, Chew said.

This makes the device sustainable enough to reduce medical waste such as bulky surgical suits.

“You can guarantee safety, whilst reducing the use of PPEs.” You reduce the number of disposables and consumables that everyone has to use,” said Gabriel Tan, Programme Director at The BioFactory.

There are no other existing measures that will allow us to resume service as efficiently