• Miguel Mayo-Yánez, Christian Calvo-Henríquez, Jérôme R Lechien, Nicolas Fakhry, Tareck Ayad, and Carlos M Chiesa-Estomba.
• Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Galicia, Spain.
• Head Neck. 2020 Jul 1; 42 (7): 1657-1663.

BackgroundGuidelines for ultrasonic devices use are imperative because infectious aerosols arising from airway procedures were a key etiologic factor in prior coronavirus outbreaks. This manuscript aims to summarize the available recommendations and the most relevant concepts about the use of ultrasonic scalpel during the SARS-CoV-2 pandemic.MethodsLiterature review of manuscripts with patients, animal models, or in vitro studies where the ultrasonic scalpel was used and the plume produced was analyzed in a quantitative and/ or qualitative way.DiscussionActivated devices with tissue produce a biphasic bioaerosol composed (size 68.3-994 nm) of tissue particles, blood, intact and no viable cells, and carcinogenic or irritant hydrocarbons (benzene, ethylbenzene, styrene, toluene, heptene, and methylpropene).ConclusionIt is imperative to use an active smoke evacuator, to avoid ultrasonic scalpel use in COVID-19 positive patients and in upper airway surgery, as well as to follow the protection recommendations of the guidelines for management this type of patients.© 2020 Wiley Periodicals, Inc.

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