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Abstract
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.
Highlights
IntroductionSurgical smoke is acknowledged as a work environment and occupational health problem, as a result of its unpleasant odor and the possibility of obstructing the view of the surgical site
The largest presence of personnel during ongoing activities was reached during liver resection surgery in the UDV operating theatres (OTs) with 14 surgical staff present in the OT at the same time, while the recorded minimum value was four persons and occurred in the OT equipped with upward displacement airflow (UWD) system
Based on the experimental measurements conducted, surgeons who have carried out a standard liver resection surgery in the OT equipped with UWD system have experienced, on average throughout the entire operation, an exposure to surgical smoke 13 times higher than in the OT equipped with the
Summary
Surgical smoke is acknowledged as a work environment and occupational health problem, as a result of its unpleasant odor and the possibility of obstructing the view of the surgical site. Besides these comfort and productivity issues, surgical smoke can cause health problems [1] to the surgical staff. Surgical smoke is generated by all ESTs, such as monopolar, bipolar and argon diathermy and other devices which use high-frequency alternating current for tissue dissection or cauterization [2]. A second large return electrode is placed in a remote side of the patient
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