467 Analysis of Surgical Smoke Generated by Electrocautery and Standard Surgical Mask Protection in a Simulated Neurosurgical Operating Room Using a Post-mortem Porcine Model for Laminectomy Exposures

Abstract

INTRODUCTION: Electrocautery is a widely used tool to coagulate and separate tissue during neurosurgical procedures. Surgical smoke generated by electrocautery has harmful properties if inhaled over long-term. To our knowledge, no efforts have been made within the neurosurgery field to investigate the air quality of operating rooms (OR) where neurosurgical procedures are being performed. METHODS: Four freshly post-mortem porcine models were used to perform 4 laminectomy exposures measuring 20cm using electrocautery in a simulated neurosurgical OR. Air sampling media and pumps were connected to a 3D-printed human face model. In 2 models the face was covered with a standard surgical mask, and in 2 models no masks were placed. The models were positioned at 40 cm distance from the surgical field. Air samples were analyzed by an independent laboratory. Analyses of total amount of respirable dust and 31 VOCs were conducted. The mean total amount between each 2 samples of the masked vs non-masked models were compared. RESULTS: On all 2 masked and 2 non-masked models, all 31 VOCs were below the levels of quantitation. On the 2 non-masked models, the total amount of respirable dust were 8.2 times higher than in the 2 masked models. CONCLUSIONS: Total amount of VOCs appears to be low at the distance measured regardless of mask use, however further studies are needed to determine if even small amounts can still be harmful over time. Standard surgical masks seem to be efficient in protecting against the high amounts of respirable dust generated by surgical smoke.