Surgical Smoke

Fan, Jicong; Chan, F.H.Y.; Chu, Kent‐Man

doi:10.1016/s1015-9584(09)60403-6

Cited by 55 publications

(65 citation statements)

References 35 publications

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“…Concerns have been raised regarding the infection risk, mutagenesis and spread of malignant cells. Exposure to surgical smoke is associated with adverse effects on the cardiovascular and respiratory system as well as with increased mortality. Surgical smoke has been demonstrated to have cytotoxic, genotoxic and mutagenic effects.…”

Section: Introductionmentioning

confidence: 99%

Experimental study of the potential hazards of surgical smoke from powered instruments

Park

Sohn

et al. 2015

British Journal of Surgery

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Viable tumour cells are produced in the surgical smoke from tumour dissection by ultrasonic scalpel. Surgical relevance Surgical smoke is a byproduct of dissection using a number of powered devices. Hazards to operating room personnel and patients are unclear. This study has shown that use of an ultrasonic dissection device can produce smoke that contains viable tumour cells. Although the model is somewhat artificial, a theoretical risk exists, and measures to evacuate surgical smoke efficiently are important.

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Section: Introductionmentioning

confidence: 99%

Experimental study of the potential hazards of surgical smoke from powered instruments

Park

Sohn

et al. 2015

British Journal of Surgery

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“…The particulate matter consists of chemicals, blood, tissue particles and bacteria. It has been demonstrated that electrosurgical devices may produce high quantities of ultrafine particles (UFP) and fine particles (FP) with diameters mostly in the range from 0.01 μm up to 1 μm [9,10,11]. Larger particle diameters are also produced, and particle peak concentrations are just close to the target tissue [12].…”

Section: Introductionmentioning

confidence: 99%

“…The potential health risks related to the exposures and inhalation of surgical smoke have been linked to acute adverse health effects in exposed healthcare workers [8,9,24,25,26,27], including: eye, nose and throat irritation, headache, cough, and nasal congestion [3,22,28,29]. Surgical smoke has been shown to induce acute and chronic inflammatory changes (e.g., emphysema, asthma, chronic bronchitis) in the respiratory tract of animal models [30,31].…”

Section: Introductionmentioning

confidence: 99%

“…The ventilation principles adopted, and their design and operation parameters, determine the contaminant control results. The performances of OT ventilation systems have been widely studied, in order to highlight their suitability and to assess the effects of the many parameters related to airborne contaminants control, e.g., airflow pattern, airflow rate, number of personnel present, adopted filtration stages, air temperature and humidity, pressurization, and frequency of door opening [9,12,18,20,22,23,52,53,54]. …”

Section: Introductionmentioning

confidence: 99%

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Electrosurgical Smoke: Ultrafine Particle Measurements and Work Environment Quality in Different Operating Theatres

Romano

Gustén

Antonellis

et al. 2017

IJERPH

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Air cleanliness in operating theatres (OTs) is an important factor for preserving the health of both the patient and the medical staff. Particle contamination in OTs depends mainly on the surgery process, ventilation principle, personnel clothing systems and working routines. In many open surgical operations, electrosurgical tools (ESTs) are used for tissue cauterization. ESTs generate a significant airborne contamination, as surgical smoke. Surgical smoke is a work environment quality problem. Ordinary surgical masks and OT ventilation systems are inadequate to control this problem. This research work is based on numerous monitoring campaigns of ultrafine particle concentrations in OTs, equipped with upward displacement ventilation or with a downward unidirectional airflow system. Measurements performed during ten real surgeries highlight that the use of ESTs generates a quite sharp and relevant increase of particle concentration in the surgical area as well within the entire OT area. The measured contamination level in the OTs are linked to surgical operation, ventilation principle, and ESTs used. A better knowledge of airborne contamination is crucial for limiting the personnel’s exposure to surgical smoke. Research results highlight that downward unidirectional OTs can give better conditions for adequate ventilation and contaminant removal performances than OTs equipped with upward displacement ventilation systems.

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“…Long duration exposure to benzene may cause anemia and some other blood disorders. 14,15 Consequently, the surgical smoke poses environmental health risk for both surgeons and the medical staff. 16,17,18 Yet, it has not been proven that it is mutagenic.…”

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confidence: 99%

Safety of Health Workers During Hyperthermic Intraperitoneal Chemotherapy Procedure

Topgül¹,

Malazgirt²,

Bişgin³

2018

TJCD

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ÖZPeritoneal karsinomatoz (PK) genellikle hastalığın son evresi olarak kabul edilir. Sitoredüktif cerrahi (SRC) ve hipertermik intraperitoneal kemoterapi (HİPEK), PK'nin potansiyel tedavi yöntemi olarak ortaya çıkmıştır. Bu multimodal prosedür, karın içinde makroskopik rezidüel tümör hacmi olmaksızın tam sitoredüksiyon elde etmeyi amaçlayan agresif multivisseral rezeksiyonları ve peritonektomiyi içerir. SRC'den sonra, ısıtılmış kemoterapi peroperatif olarak tüm periton yüzeylerini kaplayacak şekilde karın içine verilir. Böylece, yeterli intraabdominal kemoterapik ilaç konsantrasyonuna, sistemik yan etkiler olmadan ulaşılır. Hipertermi, periton kan akışını artırarak, direkt sitotoksik etkiyle ve tümör mikroçevresini değiştirerek intraperitoneal kemoterapinin etkisini artırır. Bu prosedürün uygulanması esnasında sağlık çalışanı çeşitli aşamalarda (hava yoluyla, doğrudan temasla, perfüzatlara veya kemoterapi çözeltilerine temasla ve kemoterapötiklere maruz bırakılan nesnelerin/dokuların temasıyla gibi) sitotoksik ajanlara maruz kalma riski altındadır. Ayrıca SRC sırasında hem peritoneal yüzeylerin çıkarılması hem de tümör depozitlerinin yok edilmesi esnasında yüksek voltajlı elektokoter kullanımı, sağlık çalışanını uzun saatler boyunca yüksek miktarda cerrahi dumana maruz bırakır. Bu dumanın solunması sağlık çalışanı için bir risk teşkil edebilir. SRC ve HİPEK'in güvenli bir şekilde uygulanması için kılavuz ilkeler henüz oluşturulmamıştır. Bu çalışma, SRC ve HİPEK yönetiminin güvenlik hususlarına ilişkin mevcut kanıtları özetlemektedir. Anahtar Kelimeler: Hipertermik intraperitoneal kemoterapi, sitoredüktif cerrahi, personel güvenliği Peritoneal carcinomatosis (PC) is often considered an end-stage condition. Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has emerged as the only potentially curative treatment for PC. This multimodal procedure involves aggressive multivisceral resections and peritonectomy aimed at achieving a complete cytoreduction, with no macroscopic residual tumor volume within the abdomen. After surgery, a heated chemotherapy perfusate is administered intraoperatively into the abdomen to cover all peritoneal surfaces. Thus, sufficient intraabdominal chemotherapeutic drug concentration can be achieved without systemic side effects. Hyperthermia enhances the effect of intraperitoneal chemotherapy by increasing peritoneal blood flow, by direct cytotoxic effect, and by altering the tumor microenvironment. During this procedure, the health worker is at risk of exposure to cytotoxic agents at various stages (such as through air contamination or direct contact during manipulation of perfusates or chemotherapy solutions and manipulation of objects/tissues exposed to chemotherapeutics). In addition, the use of high-voltage electrocautery during the removal of both peritoneal surfaces and tumor deposits during CRS exposes the health worker to large amounts of surgical smoke for extended periods of time. Inhalation of this smoke may pose a risk to the health-care...

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Surgical Smoke

Cited by 55 publications

References 35 publications

Experimental study of the potential hazards of surgical smoke from powered instruments

Experimental study of the potential hazards of surgical smoke from powered instruments

Electrosurgical Smoke: Ultrafine Particle Measurements and Work Environment Quality in Different Operating Theatres

Safety of Health Workers During Hyperthermic Intraperitoneal Chemotherapy Procedure

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