Is It Time for a More Systematic Approach to the Hazards of Surgical Smoke?: Reconsidering the Evidence

How should we safely handle surgical smoke?

“…Finally, there is a theoretic risk of infection secondary to bacterial and viral particles in the smoke plumes . Although it has been shown that viral DNA and blood products can be found in surgical smoke, in vivo infections are not well documented.…”

“…Finally, there is a theoretic risk of infection secondary to bacterial and viral particles in the smoke plumes. 4 Although it has been shown that viral DNA and blood products can be found in surgical smoke, in vivo infections are not well documented. Two cases exist in the literature reporting the possible transfer of the human papilloma virus from laser removal of condyloma to surgical staff, causing subsequent laryngeal papillomatosis.…”

ASI’s Consensus Guidelines: ABCs of What to Do and What Not During the COVID-19 Pandemic

“…However, it is important to recognize that open surgical procedures can generate plume with similar devices. Previous evidence identified the viral and bacterial aerosols in surgical plumes in both laparoscopic and open procedures [29][30][31][32]. Smoke evacuation device usage in line with pre-existing OR guidelines may reduce aerosol exposure in both open and laparoscopic procedures [33].…”

Surgery in times of COVID-19—recommendations for hospital and patient management

“…Furthermore, CO 2 pressure and flow should be kept to a minimum. However, since previous studies have shown that viral and bacterial aerosols can be detected in both laparoscopic and open surgical operations [27], a surgical aspirator/ smoke evacuation device should be also used in open procedures. Energy devices and electrical instruments should be utilized on the lowest energy level to avoid unnecessary production of smoke and aerosols.…”