The hazards of surgical smoke.

Surgical smoke is a part of the environment during operative and invasive procedures. As lasers and electrosurgery have become commonplace, perioperative practitioners are at increased risk for health concerns associated with exposure to surgical smoke. Since the mid 1970s, the body of evidence documenting the hazardous components of surgical smoke has continued to grow. Despite the evidence and recommendations of a variety of organizations, there are no uniform requirements mandating surgical smoke evacuation. This article reviews current research to identify the potential health hazards as well as the current recommendations related to the filtration and evacuation of surgical smoke.

[1]  D. Jewett,et al.  Exposure to blood-containing aerosols in the operating room: a preliminary study. , 1993, American Industrial Hygiene Association journal.

[2]  John Viega,et al.  Respirable particles in the excimer laser plume , 2001, Journal of cataract and refractive surgery.

[3]  K. Ball Update for nurse anesthetists. Patr 1. The hazards of surgical smoke. , 2001, AANA journal.

[4]  R. Clay,et al.  Microbiologic activity in laser resurfacing plume and debris , 1998, Lasers in surgery and medicine.

[5]  S. Pillinger,et al.  Randomized clinical trial of suction versus standard clearance of the diathermy plume , 2003, The British journal of surgery.

[6]  M S Baggish,et al.  Protection of the rat lung from the harmful effects of laser smoke , 1988, Lasers in surgery and medicine.

[7]  R. Turner,et al.  Characterization of Aerosols Produced during Surgical Procedures in Hospitals , 1995 .

[8]  R P Bleichrodt,et al.  Surgical smoke and infection control. , 2006, The Journal of hospital infection.

[9]  R. Allardyce,et al.  COMPOSITION OF VOLATILE ORGANIC COMPOUNDS IN DIATHERMY PLUME AS DETECTED BY SELECTED ION FLOW TUBE MASS SPECTROMETRY , 2007, ANZ journal of surgery.

[10]  S. L. Chen,et al.  Complications and recommended practices for electrosurgery in laparoscopy. , 2000, American journal of surgery.

[11]  R. Goodale,et al.  High levels of carbon monoxide are produced by electro-cautery of tissue during laparoscopic cholecystectomy. , 1993 .

[12]  K. Andersen Safe use of lasers in the operating room-what perioperative nurses should know. , 2004, AORN journal.

[13]  D. Braile,et al.  Speed of particles ejected from animal skin by CO2 laser pulses, measured by laser Doppler velocimetry. , 2002, Physics in medicine and biology.

[14]  S. Kunachak,et al.  The potential alveolar hazard of carbon dioxide laser-induced smoke. , 1998, Journal of the Medical Association of Thailand = Chotmaihet thangphaet.

[15]  Pratim Biswas,et al.  Analysis of surgical smoke produced by various energy-based instruments and effect on laparoscopic visibility. , 2007, Journal of endourology.

[16]  Nader N Massarweh,et al.  Electrosurgery: history, principles, and current and future uses. , 2006, Journal of the American College of Surgeons.

[17]  Mary J. Ogg,et al.  Recommended Practices for Electrosurgery , 2012 .

[18]  Recommended practices for laser safety in practice settings. , 2004, AORN journal.

[19]  D. Sharpe,et al.  Surgical smoke without fire: the risks to the plastic surgeon. , 2004, Plastic and reconstructive surgery.

[20]  K. Stenson,et al.  Effects of plume produced by the Nd:YAG laser and electrocautery on the respiratory system , 1993, Lasers in surgery and medicine.

[21]  C. N. Dikes Is it safe to allow smoke in our operating room? , 1999, Today's surgical nurse.

[22]  G. Ortega-Pérez,et al.  Safety considerations for operating room personnel during hyperthermic intraoperative intraperitoneal chemotherapy perfusion. , 2006, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.

[23]  J. Fletcher,et al.  Dissemination of melanoma cells within electrocautery plume. , 1999, American journal of surgery.

[24]  M. O’Banion,et al.  Viral disease transmitted by laser-generated plume (aerosol). , 2002, Archives of dermatology.

[25]  R. Turner,et al.  Characterization of aerosols produced during total hip replacement surgery in dogs with 51Cr-labeled blood , 1995 .

[26]  M. Sigrist,et al.  Smoke in the operating theater: an unregarded source of danger. , 2004, Plastic and reconstructive surgery.

[27]  E. Berber,et al.  The use of the harmonic scalpel vs conventional knot tying for vessel ligation in thyroid surgery. , 2002, Archives of surgery.

[28]  B. Ulmer Occupational Safety and Health Administration acts on guidelines for electrosurgical smoke. , 1998, AORN journal.

[29]  C. Romig,et al.  Regulation of surgical smoke plume. , 1997, AORN journal.

[30]  S. Garber,et al.  Surgical smoke: a review of the literature , 2003, Surgical Endoscopy And Other Interventional Techniques.

[31]  Summer R. Youker,et al.  Practical Aspects of Laser Safety , 2001, Facial plastic surgery : FPS.

[32]  T M Fliedner,et al.  Laser pyrolysis products-genotoxic, clastogenic and mutagenic effects of the particulate aerosol fractions. , 1999, Mutation research.

[33]  B. Giordano Don't be a victim of surgical smoke. , 1996, AORN journal.

[34]  D. Beebe,et al.  High Levels of Carbon Monoxide Are Produced by Electro‐Cautery of Tissue During Laparoscopic Cholecystectomy , 1993, Anesthesia and analgesia.

[35]  J. Murphy,et al.  The Mutagenicity of Electrocautery Smoke , 1992, Plastic and Reconstructive Surgery.

[36]  Ma Hui-lan Analysis of monitoring results of the air quality in the operating room , 2004 .