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Re: Anal/Vaginal Warts

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#69697
Michael Wishart
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Author:
Michael Wishart

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Michael.Wishart@hsn.org.au

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Hi Ruth

That is a good question, with a difficult answer! In Australia, high filtration masks are considered P2 masks, which is similar to the N95 standard in the US, (not the same though). In the US, they also sell “laser plume” masks”, which are not considered N95 masks, but are designed to protect from “laser plume”.

My opinion is that if you have very good local exhaust extraction for surgical cutting that may create aerosols (“surgical smoke”), then the type of masks is not as important. Many theatres even in Australia use “laser plume masks” for surgical cutting specifically with lasers, but not with all Electrocautery.

There is no real simple answer as to which is the “best” mask for this purpose, as the risks are still not fully identified. Ask the mask manufacturers what their recommendations are for their masks, and what evidence they have to support this.

Hopefully others on the list may have more advice on this.

Cheers
Michael

Michael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3607 2226
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
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Dear Michael,
I guess that raises another question. What is the best surgical mask in Australia to use in OT that would be appropriately called a High filtration surgical masks?

Ruth Dalrymple
Quality Risk/Infection Control Co-Ordinator
Hurstville Private Hospital
37 Gloucester Road, Hurstville NSW 2220, Australia
T 9579 7773 F 9586 2311
E Ruth.Dalrymple@healthecare.com.au W

Hi Ruth

I think this is referring to ‘laser plume’ as a mechanism for transmission of papillomavirus. Electrocautery is also a risk, but less well identified.

The main risk minimisation for these types of procedures is to use well-fitting masks, and use a local exhaust suction system to minimise aerosol dispersal. I am sure there are many guidelines to this effect available. Obviously using different treatments for these warts where this is an option should also be considered.

Cheers
Michael

Michael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3607 2226
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
Please consider the environment before printing this email

Dear All,
I was wondering if anyone could tell me any extra precautions necessary, when operating on a patient with vaginal and anal warts. There was apparently a claim that when the warts are diathermied off, it would cause the virus to become airborne? I was asked to check up on it. Is there any truth in this statement?
Regards

Ruth Dalrymple
Quality Risk/Infection Control Co-Ordinator
Hurstville Private Hospital
37 Gloucester Road, Hurstville NSW 2220, Australia
T 9579 7773 F 9586 2311
E Ruth.Dalrymple@healthecare.com.au W
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