Abstract
This study aimed to compare the concentration of surgical smoke produced by different tissues and electric diathermy modes and to measure the effectiveness of various local exhaust ventilations. We compared the surgical plume concentration from different tissues and settings with a porcine tissue model. We also compared the efficiency of three local exhaust ventilations: (1) a desktop unit (Medtronic Rapid Vac), (2) a central evacuation system with ENT suction, and (3) a central evacuation system with a urethral catheter (PAHSCO Urethral Catheter). In the cutting setting, the skin tissue had a higher concentration of total suspended particulates (TPS), which were 1990 ± 2000 (mean ± SD, μg/m3), 6440 ± 3000 and 9800 ± 2300 at 15, 30 and 45 s, respectively (p < 0.05). In the coagulation setting, the adipose tissue had a higher concentration of TPS, which were 3330 ± 2600, 11,200 ± 5500 and 15,800 ± 7300, respectively (p < 0.05). We found that all three smoke extractors had more than 96% efficiency in clearing surgical smoke. With electric diathermy, skin tissue in the cutting model and adipose tissue in the coagulation mode will produce higher concentration of particles within surgical plumes. An electric surgical scalpel adapted with a urethral catheter is a simple and effective way to exhaust smoke in surgical operations.
Highlights
This study aimed to compare the concentration of surgical smoke produced by different tissues and electric diathermy modes and to measure the effectiveness of various local exhaust ventilations
With our porcine tissue model, we found that the concentrations of each particle increased gradually with prolonged diathermy duration (Table 1 and Fig. 3A–F)
We found that the total suspended particulates (TSP) had a positive correlation with the duration of diathermy in both cutting and coagulation modes (p < 0.01, Table 2)
Summary
This study aimed to compare the concentration of surgical smoke produced by different tissues and electric diathermy modes and to measure the effectiveness of various local exhaust ventilations. Skin tissue in the cutting model and adipose tissue in the coagulation mode will produce higher concentration of particles within surgical plumes. No study has compared the surgical smoke produced by different electric diathermy mode, and the effectiveness of various smoke evacuation systems requires a robust assessment[12]. We chose the electric diathermy with coagulation mode over muscular tissue, which was the most commonly encountered during head and neck surgery, to evaluate the efficiency of LEV. The purpose of this study was to measure the surgical smoke produced by different tissues and to compare the effectiveness of different local exhaust ventilators
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