Analysis of influencing factors on the concentration change of fine particulate matter (PM2.5) in surgical smoke during surgical field exposure in open surgeries

Abstract

Objective To investigate the changes and influencing factors of fine particulate matter (PM2.5) concentration in surgical smoke during surgical field exposure in open surgeries. Methods From May to August 2017, 124 cases of open surgery in the Operating Room of the First Hospital of Peking University were selected. The concentration of PM2.5 inside and outside the laminar flow area and 50 cm from the incision was measured by JC-M9 dust detector. The general data, power of electrosurgical scalpel, use time and PM2.5 concentration (maximum immediate value) were collected by self-made questionnaire, and the influencing factors of PM2.5 concentration were analyzed. Results When 124 patients were exposed to high frequency electrosurgical knife, the power range of electrosurgical knife was 30-60 W, the highest concentration of PM2.5 was 3 972 μg/m3, the lowest was 0, the average concentration was (130.17±408.36) μg/m3, the median was 18.00 μg/m3. Univariate analysis showed that the differences of PM2.5 concentration were statistically significant (Z=-7.33, -3.04, -6.60, -2.08; P<0.05) . Linear regression analysis showed that whether in the laminar flow area and the waist circumference of patients were the influencing factors of PM2.5 concentration change during the field exposure (P<0.05) . Conclusions The PM2.5 concentration measured in laminar flow area was higher than that outside laminar flow area, and the PM2.5 concentration of patients with normal waist circumference was higher than that of people with excessive waist circumference. Before the operation, the medical staff in the operating room should evaluate the operation site and the general information of the patients, maintain the effective negative pressure suction during the operation, keep the closed negative pressure state in the operating room, and improve the protection awareness of the medical staff to the operation smoke. Key words: Intraoperative; Fine particulate matter; Surgical smoke; PM2.5; Quality of air; Influencing factors