Quantification of fluorescein droplets and reporting of data
Each surgeon undertook five simulated tonsil procedures. The Coblation wand was activated on the strawberries for five minutes (Figure 1d) before the surgical field and surgeon was assessed for fluorescein droplet deposition using an ultraviolet (UV) lamp. The presence of droplet was assessed in binary fashion: present or not present. The results were collated as frequency of droplet detection and illustrated as a heatmap; 0 = white, 1-2 = yellow, 3-4 = orange and 5 = red.
For the surgical field, a 10cm diameter circle was cut out of the epicentre of the black square sheet to allow access into the oropharynx. A 30cm line was drawn to each corner of the square to divide it into four quadrants representing areas within the immediate surgical field. Another black square sheet measuring 42cm x 42cm was placed over the pillow (Figure 2a). The surgeon was assessed based on anatomical subsites (Figure 2b): hands, forearm, upper arm, chest, neck, face visor and the area under the visor (mask and upper face).
The surgical field was then cleaned and re-checked with the UV lamp. Remnant strawberries were carefully removed and replaced with fresh fluorescein-soaked pieces. The Coblation wand was cleaned and activated externally to ensure both irrigation and suction was functioning properly. The surgeon’s PPE was also cleaned and where necessary, changed.