Surgical Smoke – The Facts
Surgeons and staff are routinely exposed to smoke, plume and aerosols produced by instruments used to dissect tissue and provide haemostasis. Long-term effects for healthcare workers remain relatively unclear due to limited evidence, however the need still remains for a proactive approach to reduce the potential patient and clinical staff exposures.
Here are 5 things you need to know about surgical smoke:
Research indicates surgical smoke is a significant chemical and biological hazard and has shown to be as mutagenic as cigarette smoke.
Analysis of surgical smoke using porcine model concluded the mutagenic potency of condensates (from 1g of tissue destroyed through electrocautery) to be equivalent to smoking 6 unfiltered cigarettes.
One study set out to discover how much surgical smoke was produced in operating rooms, where the total daily duration of diathermy use was electronically recorded over a two month period.
The study found that on average the smoke produced on a daily-basis was the equivalent to the amount produced by 27-30 cigarettes.
Harmful chemicals found in the plume can include: Carbon Monoxide; Formaldehyde; Hydrogen Cyanide; Methane; Benzene; Toluene; Phenol and Styrene.
In addition to this, viruses and bacteria such as HIV and HPV can be transmitted through surgical smoke.
A multi-specialty survey performed by the Royal College of Surgeons reported that only 3% of surgeons used smoke extraction devices in their practice.
In British theaters, the air must be exchanged every 3 minutes - although this has some impact on air recycling the highest concentration of plume still passes directly through the surgeons facial field.
Surgical masks are inadequate in filtering either smaller smoke particles or the larger, non-combusted cellular components.
One study which looked at the efficiency of surgical masks found that: “Surgical masks do not provide measurable protection against surgical smoke."
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