What Are Ultra-Low Particulate Air Filters?

The particle penetration removal efficiency of the High Efficiency Particulate Air (HEPA) and Ultra Low Particulate Air (ULPA) filters were studied by using of mono-disperse liquid aerosols of Di-Octyl Phethalate (DOP) under vary operational conditions. The effects of different operational factors, including the particle size, the face velocity and pressure drop were investigated in this study. The results indicated that the most penetrating particle size through the ULPA and HEPA filters was approximately 0.1-0.12 µm. Brown diffusion effect is suggested mechanism for particle size removal mechanism of 0.1 µm and less while impaction and interception mechanisms are explained the behavior of HEPA and ULPA filters for removal of 0.12 µm and more particle size. The penetrations of particle through both kind of filters were increased with increasing of face velocity. Additionally, the pressure drop of filter is increased versus the rising of face velocity. The cost of energy is lower in low face velocity of filters.

Personal protective equipment in the decontamination area Key words: decontamination, personal protective equipment (PPE), barrier level, droplets, sterile processing. Administering opioids to patients with obstructive sleep apnea Key words: opioids, obstructive sleep apnea (OSA), moderate sedation and analgesia, respiratory depression, positive-pressure ventilation. Surgical smoke evacuation during Mohs surgery Key words: Mohs, surgical smoke, evacuation, filtration, wall suction. Using built-in trocar filters for surgical smoke safety Key words: ultra-low particulate air filtration, activated carbon filtration, built-in trocar filter, volatile organic compound (VOC), minimally invasive surgery (MIS).

Introduction Electrosurgery exposes healthcare workers to volatile organic compounds (VOCs) including formaldehyde. Adopting electrosurgical devices that catalytically transform formaldehyde to benign substances has the potential to improve safety in surgical settings. Materials and methods We compared the efficiency of formaldehyde removal of two medical devices.The first was a novel surgical vacuum (SV) device containing ultra-low particulate air (ULPA) filtration, activated carbon and catalytic transition metal oxide.The second was a commonly utilized handpiece evacuator (HE) that contained only mechanical filtration and activated carbon granules. Both devices were exposed to formalin vapor. Results The time weighted average (TWA), median and peak concentrations of detected formaldehyde at the outflow of the SV unit were 90% lower than the corresponding values detected at the outflow of the HE device (p = 0.0034). When catalytic material was added to the HE device, the detected formaldehyde concentration at the outflow was reduced by 55%(p = 2.9 x 10-15). Conclusions The catalytic SV device has the potential to considerably reduce formaldehyde levels in operating room (OR) environments.

For applications such as face masks and medical gowns, defects can pose a threat to the reliability of protective materials. Roping, the entanglement of two or more fibers in a nonwoven, can cause a decrease in pore size uniformity, filtration efficiency, and barrier properties in meltblown nonwovens. In this work, a novel measurement methodology for roping was developed utilizing SEM images, ImageJ software, and statistical analysis with R. The study analyzed 16 different meltblown nonwovens with two different die tips with a 1550 MFR polypropylene, utilizing a full factorial design with 4 factors at 2 levels. A model was developed for the mitigation of roping, and it was determined that the interactions of capillary density with air flow and air flow with die-to-collector distance (DCD) had the greatest impact on the formation of roping in meltblown nonwovens. The fundamental learnings of the effects of the process parameters on roping formation could be applied to industrial applications such as face masks to tailor the balance between filtration efficiency and air permeability. The linear model could be directly applied to applications such as HEPA (High Efficiency Particulate Air) and ULPA (Ultra Low Particulate Air) filters, for operating room and clean room filters, in which nonuniformity and loss of surface area critical to performance, and thus the mitigation of roping would be beneficial.

Occupational human papillomavirus vaccination for health care workers Key words: human papillomavirus (HPV), vaccination, occupational exposure, surgical smoke. Respiratory protection during smoke-generating treatment of human papillomavirus lesions Key words: human papillomavirus (HPV), respiratory protection, surgical smoke evacuation, surgical N95 respirator, loop electrosurgical excision procedure (LEEP). Most penetrating particle size in air filtration media testing Key words: most penetrating particle size (MPPS), ultra-low particulate air (ULPA), filtration efficiency, filtration media, surgical smoke evacuation. Smoke evacuation in surgical simulation laboratories Key words: surgical smoke evacuation, simulation laboratories, surgical energy devices, surgical smoke safety.

Purpose Cleanrooms are highly controlled enclosed rooms where air quality is monitored and ensured to have less contamination according to standard cleanliness level. Air filters are used to optimize indoor air quality and remove air pollutants. Filter media and filtering system are decided as per requirement. Depth filter media are mostly used in cleanroom filtrations. This paper aims to present a comprehensive review of the evolution of cleanroom filter media. It evaluates the advantages and disadvantages of air filter media. It is also studied which air filters have additional properties such as anti-microbial properties, anti-odour properties and chemical absorbent. Development and innovation of air filters and filtration techniques are necessary to improve the performance via the synergistic effect and it can be a possible avenue of future research. Design/methodology/approach This paper aims to drive the future of air filter research and development in achieving high-performance filtration with high filtration efficiency, low operational cost and high durability. Air pollutants are classified into three types: suspended particles, volatile organic pollutants and microorganisms. Technologies involved in purification are filtration, water washing purification, electrostatic precipitation and anion technology. They purify the air by running it through a filter medium that traps dust, hair, pet fur and debris. As air passes through the filter media, they function as a sieve, capturing particles. The fibres in the filter medium provide a winding path for airflow. There are different types of air filters such as the high-efficiency particulate air filter, fibreglass air filter and ultra-low particulate air filter. Findings Emerging filtration technologies and filters such as nanofibres, filters with polytetrafluoroethylene membrane are likely to become prevalent over the coming years globally. The introduction of indoor air filtration with thermal comfort can be a possible avenue of future research along with expanding indoor environment monitoring and improving air quality predictions. New air filters and filtration technologies having better performance with low cost and high durability must be developed which can restrict multiple types of pollutants at the same time. Originality/value The systematic literature review approach used in this paper highlights the emerging trends and issues in cleanroom filtration in a structured and thematic manner, enabling future work to progress as it will continue to develop and evolve.

Smoke Evacuator Use with Ultra-Low Particulate Air Filtration in Rhinoplasty and Sinus Surgery.

The recent COVID-19 pandemic has required careful reconsideration of safe operating room practices. We describe our initial experiences performing otologic surgery with the exoscope during the COVID-19 pandemic. The exoscope was used for several semiurgent otologic surgeries in combination with complete eye protection, a "tent" drape, a smoke evacuator with ultra-low particulate air filter, and betadine irrigation. These techniques are demonstrated in the accompanying video. This was compared with our experiences using the microscope. The described modified goggles allowed complete eye protection while providing a fully three-dimensional view of the surgical site. The other safety measures described are simple and efficient techniques which can easily be adopted for otologic surgery using the microscope. Use of the exoscope for otologic surgery during the COVID-19 pandemic allows full three-dimensional visualization of the surgical field while simultaneously providing complete eye protection. Use of the "tent" drape, ultra-low particulate air filter, and betadine irrigation are also options that otologic surgeons may consider for additional safety.

Invasive fungal infections incidence in patients with hematological malignancies is increasing. Air treatment remains an essential preventive measure. Guidelines state that high-risk patients should be housed in units equipped with High-Efficiency Particulate Air filtration. Mobile air-treatment devices may be considered as alternatives or as a complement to the ventilation system. We assessed the decontamination performances of a new mobile air-treatment device in a conventional hematology room. This device connected or not to a plenum combining Ultra-Low Particulate Air filtration and non-thermal catalysis process has been evaluated with or without healthcare activities (one sampling at-rest and triplicate samplings in activity). Environmental particulate, airborne and surface fungal and total mesophilic flora (TMF) samplings were performed with a total of 1800 min of particles counting, 144 air and 240 surface samplings. At-rest, both devices achieved a 2-log decrease of airborne particles, ISO 4 being the maximal particle class reached under the plenum. Whatever the healthcare activities and the location in the room, ISO 7 was the maximal particle class reached. TMF and fungal air contamination were lower during healthcare activities when the air portable cleaners were running. The bed was the area the least contaminated in the room. No differences were observed for surface contamination. This work provides arguments of the efficacy of a new mobile air-treatment device to decrease particle counts and airborne bioburden in real-life conditions. Studies have yet to be conducted to document the impact of these devices on the risk of invasive aspergillosis in immunocompromised patients.

Ventilation/Perfusion scanning for suspected pulmonary embolism is undergoing a renaissance due to the advent of single-photon emission computed tomography (SPECT). The scan protocol demands the inhalation of a radioactive gas or vapour for the ventilation scan. The purpose of this article is to report the radioactive environmental contamination that can occur when Tc Technegas vapours are administered to patients for the ventilation SPECT scan. This contamination can concentrate within gamma camera heads to degrade images and is also a radiation hazard to staff. A method for sequestrating this airborne contamination was investigated using an ultra-low particulate air filter. The prevalence of radioactive contamination and the levels of contamination captured were quantified and only 36% of patients were found to have undergone the ventilation procedure without producing significant airborne contamination. Advice is given on best practice that will minimize airborne contamination and minimize the risks to staff working in the Nuclear Medicine department. The use of an extraction/filtration device may be seen as an effective additional control measure against airborne radioactive contamination for health professionals.

Background: COVID-19 era has put laparoscopic surgery a risk procedure because of theoretical risk of viral transmission of COVID-19. However, safe evacuation of stagnant air during laparoscopic surgery is also necessary to safeguard health care warriors. Methods: We are reporting experience of 24 laparoscopic surgeries using a closed smoke evacuation/filtration system using a ultra low-particulate air (ULPA) filtration capability (ConMed AirSeal® System) at a single center between March 22, 2020, and May 30, 2020. All surgeries were either urgent or emergency in nature. Results: Totally, 17 males and 7 females who required urgent surgery. Most common indication for laparoscopic intervention was acute cholecystitis and complications related to acute cholecystitis. Owing to the closed smoke evacuation system, low intra-abdominal pressure was maintained during all surgeries. Of all procedures, only 0.8 time per procedure, the laparoscope taken out for cleaning. Mean time for completion of surgery was 58 minutes. Compliance of surgical staff was high due to the deemed safe smoke evacuation system. Mean of postoperative pain score was low. Mean hospital stay was 4.9 days. Conclusions: We propose to use a closed smoke evacuation/filtration system with ULPA filtration capability or similar devices in each minimally invasive surgery to reduce risks of transmission as minute as possible until we have enough knowledge about the pattern of disease transmission.

Smoke Evacuation Filters After the COVID-19 Pandemic

This study aimed to evaluate the efficacy of smoke filters for use in endoscopic surgery and their significance during the present COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The literature was reviewed by analyzing articles on PubMed using the search terms “smoke”, “filter”, and “laparoscopy”. A systematic literature search revealed six smoke filter clinical studies pertinent to endoscopic surgery. The studies focused on the different aspects and efficacy of these filters: (1) UGF1 filter (Pall Biomedical, St. Germaine en Laye, France) investigated captured mesothelial cells and other debris, (2) Valve-less trocar AirSeal™ (SurgiQuest, Orange, CT) fitted with an ultra-low particulate air (ULPA) filter investigated smoke evacuation and filtration to reduce exposure of staff to hazardous fumes, (3) automatic smoke evacuator (IES2, ERBE) equipped with ULPA identified 37 filtered carcinogenic substances, (4/5) the Tropian trocar (Tropian Tech., Gunpo, Korea), a charcoal filter, investigated in two studies focused on filtration of further hazardous compounds, and (6) charcoal/ULPA combination filter by Dyeing and Finishing Technology Institute investigated filtration rates of volatile organic compounds. Surgical plume can be cleared of hazardous chemical through smoke filters. There were six different filter studies identified with regards to endoscopic surgery which can aid in protecting the surgical staff from dangerous smoke by filtering cells, recirculating, and filtering gas, and removal of carbon-based substances. No clinical study has specifically investigated the removal of viruses by smoke filters including the SARS-CoV-2.

The coronavirus disease 2019 (COVID-19) pandemic has had a global impact on all aspects of health care, including surgical procedures. For urologists, it has affected and will continue to influence how we approach the care of patients preoperatively, intraoperatively, and postoperatively. A risk-benefit assessment of each patient undergoing surgery should be performed during the COVID-19 pandemic based on the urgency of the surgery and the risk of viral illness and transmission. Patients with advanced age and comorbidities have a higher incidence of mortality. Routine preoperative testing and symptom screening is recommended to identify those with COVID-19. Adequate personal protective equipment (PPE) for the surgical team is essential to protect health care workers and ensure an adequate workforce. For COVID-19 positive or suspected patients, the use of N95 respirators is recommended if available. The anesthesia method chosen should attempt to minimize aerosolization of the virus. Negative pressure rooms are strongly preferred for intubation/extubation and other aerosolizing procedures for COVID-19 positive patients or when COVID status is unknown. Although transmission has not yet been shown during laparoscopic and robotic procedures, efforts should be made to minimize the risk of aerosolization. Ultra-low particulate air filters are recommended for use during minimally invasive procedures to decrease the risk of viral transmission. Thorough cleaning and sterilization should be performed postoperatively with adequate time allowed for the operating room air to be cycled after procedures. COVID-19 patients should be separated from noninfected patients at all levels of care, including recovery, to decrease the risk of infection. Future directions will be guided by outcomes and infection rates as social distancing guidelines are relaxed and more surgical procedures are reintroduced. Recommendations should be adapted to the local environment and will continue to evolve as more data become available, the shortage of testing and PPE is resolved, and a vaccine and therapeutics for COVID-19 are developed.

Background:Amid the coronavirus disease 2019 (COVID-19) pandemic, dermatologists must be prepared to restructure their practice of procedural dermatology and cutaneous aesthetic surgeries. The COVID-19 pandemic has presented several challenges and has ushered in several changes in practice such as teledermatology, with many physicians adopting virtual consultations and treatments. Performing procedures in the times of COVID-19 pandemic presents challenges such as risk of transmission to doctors and staff due to potential aerosolization, release of virus droplets during the procedures, and risk of virus transfer through the instruments both in the peri- and postoperative period. This can have several medical, administrative, and legal implications.Objectives:This document aimed to outline best practices that can be followed in this scenario to perform cutaneous surgeries and procedures to ensure safer skin surgery.Recommendations:Standard precautions include social distancing of at least 1 m, hand hygiene, appropriate use of personal protective equipment (PPE), safe injection practices, sterilization and disinfection of medical devices, environmental cleaning, and respiratory hygiene. It is generally advisable to see patients only by appointments. Each clinic should have a special area at entry for screening patients and providing sanitizers and masks. Procedures, which are of short duration, performed on nonfacial areas are considered as low risk and require donning surgical mask. Procedures involved with minimal invasiveness and bleeding, short duration procedures on the face such as injectables, chemical peels, and aerosol-generating procedures on nonfacial areas are considered moderate risk. These procedures need apron with head cover, N95 mask, face shield, double gloves, and smoke evacuator with high-efficiency particulate air (HEPA) or ultralow particulate air (ULPA) filter. Aerosol and plume-regenerating procedures (such as ablative lasers on the face), prolonged surgeries on head (such as hair transplantation), intraoral, and intranasal procedures are considered high risk. These procedures must be carried out with full body cover with surgical gown, head cover, N95 mask, face shield, double gloves, and smoke evacuator. Physicians should be aware of local epidemiological situation and adhere to the relevant guidelines issued by the relevant governmental agencies.

Size-dependent efficiencies of ultrafine particle removal of various filter media