The Mutagenicity of Electrocautery Smoke

Gatti, John M.; Bryant, Charles; Noone, R. Barrett; Murphy, J. Brien

doi:10.1097/00006534-199205000-00001

Cited by 103 publications

(52 citation statements)

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“…Different target tissues produce varying amounts of smoke with different characteristics. Factors that can affect the amount and content of smoke include the type of procedure, the surgeon's technique, the pathology of the target tissue (e.g., whether particular bacteria or viruses are present), the type of energy imparted, the power levels used, and the amount of cutting, coagulation, or ablating performed [5].…”

Section: Generalmentioning

confidence: 99%

“…In addition, the mutagenicity of electrocautery smoke has been estimated to be at least that of cigarette smoke [14], and has been further shown to vary in mutagenicity, depending on the type of tissue ablated [5,15]. Benzene has been proposed to be highly responsible for the mutagenicity of electrocautery smoke.…”

Section: Electrocauterymentioning

confidence: 99%

“…Smoke has been shown to be mutagenic and therefore genotoxic [5,14,15]. The specific method of genotoxicity is most likely multifactorial and may include chemical and biologic modalities.…”

Section: Genotoxicitymentioning

confidence: 99%

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Surgical smoke: a review of the literature

2003

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Surgical smoke is omnipresent in the day-to-day life of the surgeon and other medical personnel who work in the operating room. In addition, patients are also exposed, especially and uniquely so in laparoscopic cases where smoke is created and trapped in a closed and absorptive space. Surgical smoke has typically been produced by electrocautery but is now ever more present in a new form with the burgeoning use of the laser and the harmonic scalpel. Several cases of transmission of human papillomavirus (HPV) from patient to treating professional via laser smoke have alerted us to the reality that surgical smoke in certain situations is far form benign. However, surgeons rarely take measures to protect themselves, their co-coworkers and patients from surgical smoke. Should we and, if so, how do we differentiate between different types of smoke and should we move toward increasing our efforts to protect ourselves, our co-workers, and patients from it? This article attempts to sort through the available data and draw some reasonable conclusions regarding surgical smoke. In general, surgical smoke is a biohazard and cannot be ignored. At a minimum, surgical smoke is a toxin similar to cigarette smoke. However, other dangers exist. This is especially true in specific circumstances such as when tissue infected with dangerous viruses is aerosolized by lasers. In addition, smoke generated by the harmonic scalpel, being a relatively cold vapor similar to laser smoke, should be further investigated for its potential ill effects and until then, looked upon with reasonable caution. Although not a high-priority in most surgical cases, surgeons should support efforts to minimize OR personnel, patients, and their own exposure to surgical smoke.

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Section: Generalmentioning

confidence: 99%

Section: Electrocauterymentioning

confidence: 99%

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Surgical smoke: a review of the literature

2003

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“…Electrosurgical smoke contains charred debris, cellsize fragments, breathable aerosols, and various complex organic chemicals [2]. The toxic, infective, and mutagenic risks of electrosurgical smoke generated during conventional open surgery are well documented [3,7]. Use of smoke evacuation devices and safety precautions against inhalation by theater staff have been advocated during open surgery [6].…”

mentioning

confidence: 99%

Chemical composition of smoke produced by high-frequency electrosurgery in a closed gaseous environment

et al. 1998

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“…Various chemicals, including aldehydes, benzene, toluene, acrolein, hydrocyanic gases, and CO, have been identified in the plume [6,[12][13][14][15]. Consequently, laser and electrocautery smoke caused by the pyrolysis of tissue has been shown to be cytotoxic, genotoxic, mutagenic, and clastogenic [6,11,[22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Surgical smoke management for minimally invasive (micro)endoscopy: an experimental study

et al. 2010

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Surgical smoke evacuation from endoscopic cavities that are as small as 2 cm in diameter via minimally invasive ports as small as 20 G (0.9 mm) in diameter may be safe and efficient if sufficient gas exchange is provided during smoke generation by laser or electrosurgical instruments. However, maintaining a low and constant pressure in the cavity during gas exchange and adopting a special construction design for the suction tube are essential to provide an excellent view during the surgical maneuver and to minimize potential toxic side effects of the smoke.

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The Mutagenicity of Electrocautery Smoke

Cited by 103 publications

References 0 publications

Surgical smoke: a review of the literature

Surgical smoke: a review of the literature

Chemical composition of smoke produced by high-frequency electrosurgery in a closed gaseous environment

Surgical smoke management for minimally invasive (micro)endoscopy: an experimental study

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