Surgical smoke and infection control

Alp, Emine; Bijl, Dick; Bleichrodt, R. P.; Hansson, B.; Voß, Andreas

doi:10.1016/j.jhin.2005.01.014

Cited by 304 publications

(355 citation statements)

References 16 publications

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“…The US Occupational Safety and Health Administration estimates that 500,000 employees working in operating theaters are exposed to electrosurgical and laser smoke annually [1]. Electrocautery smoke is considered a toxin similar to cigarette smoke [2].…”

Section: Introductionmentioning

confidence: 99%

Chemical Production in Electrocautery Smoke by a Novel Predictive Model

Tang

Huang

et al. 2011

Eur Surg Res

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Objectives: The hazards of electrocautery smoke have been known for decades. However, few clinical studies have been conducted to analyze the responsible variables of the smoke production. This study collected clinical smoke samples and systematically analyzed all possible factors. Methods: Thirty diathermy smoke samples were collected during mastectomy and abdominal cavity operations. Samples were analyzed using a gas chromatographer with a flame ionization detector. Data were applied to construct prediction models for chemical production from electrosurgeries to identify all possible factors that impact chemical production during electrosurgery. Results: Toluene was detected in 27 smoke samples (90%) with concentrations of 0.003–0.463 mg/m³ and production of 176.0–2,780.0 ng. Ethyl benzene and styrene were identified in very few cases. General linear regression analysis demonstrates that surgery type, patient age, electrocautery duration and imparted coagulation energy explained 67.63% of the variation in toluene production. Conclusion: Surgery type and patient age are known prior to surgery. In terms of risk precaution, the operating team should pay close attention to exposure when certain positive factors of increasing the chemical production are known in advance.

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Section: Introductionmentioning

confidence: 99%

Chemical Production in Electrocautery Smoke by a Novel Predictive Model

Tang

Huang

et al. 2011

Eur Surg Res

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“…Clinical pulmonary infection score was used to diagnose occurrence of ventilator associated pneumonia. 10,11 This scoring system serves as a tool to assist in diagnosis of ventilator associated pneumonia. The clinical pulmonary infection score is calculated on the basis of points assigned for various signs and symptoms of pneumonia.…”

Section: Methodsmentioning

confidence: 99%

Incidence of ventilator associated pneumonia in tracheostomised and non tracheostomised patients

Rosario

Sequeira

2018

Int J Res Med Sci

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Background: Pneumonia is the most common hospital acquired infection in the intensive care unit. One of the causes for hospital acquired pneumonia is ventilator associated pneumonia. Tracheostomy is known to prevent occurrence of ventilator associated pneumonia as it decreases the respiratory dead space, assists in better clearance of secretions and prevents chances of aspiration. Generally, tracheostomy is done after 2 weeks of endotracheal intubation to prevent tracheal complications. The aim of this study is to identify the incidence of ventilator associated pneumonia in tracheostomised and non tracheostomised patients and to see if early tracheostomy can prevent development of ventilator associated pneumonia.Methods: The study was conducted at a tertiary care hospital during a period of four years. 100 patients who were on mechanical ventilation for more than 7 days where taken up for the study. APACHE 4 scoring system was used. The incidence of Ventilator associated pneumonia in tracheostomised and non tracheostomised patients was studied.Results: In our study the total incidence of VAP was 44 %. In our study out of the 42 patients who had undergone tracheostomy 13 (30.95%) patients had ventilator associated pneumonia. Among the non-tracheostomised patients 31 (53.44%) out of 58 patients developed ventilator associated pneumonia. In our study the incidence of ventilator associated pneumonia was much lesser (12%) in patients who underwent tracheostomy in the period 7 to 10 days after mechanical ventilation, whereas in those who underwent tracheostomy after 11 days incidence of ventilator associated pneumonia was much higher.Conclusions: Our study showed that the incidence of ventilator associated pneumonia was much higher among non tracheostomised patients compared to patients who underwent tracheostomy. Hence patients undergoing earlier tracheostomy had a clear advantage than those undergoing tracheostomy late or non tracheostomised patients in preventing ventilator associated pneumonia.

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“…Surgical smoke can produce nausea, headache, eye irritation, respiratory tract irritation, cardiovascular changes, obstruct visualization of the surgical field and has a bad smell [19,20].…”

Section: Chemical Composition Of Electrosurgical Smoke and Its Hazardsmentioning

confidence: 99%

Safety considerations for Health care Workers involved in Cytoreductive Surgery and Perioperative chemotherapy

Bhatt

Mittal

Gopinath³

2016

Indian J Surg Oncol

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The combined modality treatment of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has gained worldwide acceptance for management of selected patients with peritoneal metastases from various cancers. Cytoreductive surgery is performed with the goal of removing all macroscopic disease and is coupled with perioperative chemotherapy (POC) in the form of HIPEC with or without EPIC (early postoperative intraperitoneal chemotherapy) to deal with the microscopic residual disease. These treatments entail the use of cytotoxic drugs in the operation theatre or in the intensive care unit where they are not commonly used and put the healthcare workers participating in the treatment at risk of exposure. CRS is performed with high voltage electrocautery generating a large amount of surgical smoke which is inhaled by the involved personnel and has potential health hazards. This article outlines the safety measures to be taken while performing CRS and POC.

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Surgical smoke and infection control

Cited by 304 publications

References 16 publications

Chemical Production in Electrocautery Smoke by a Novel Predictive Model

Chemical Production in Electrocautery Smoke by a Novel Predictive Model

Incidence of ventilator associated pneumonia in tracheostomised and non tracheostomised patients

Safety considerations for Health care Workers involved in Cytoreductive Surgery and Perioperative chemotherapy

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