Abstract
BackgroundOperating room personnel have the potential to be exposed to surgical smoke, the by-product of using electrocautery or laser surgical device, on a daily basis. Surgical smoke is made up of both biological by-products and chemical pollutants that have been shown to cause eye, skin and pulmonary irritation.MethodsIn this study, surgical smoke was collected in real time in cell culture media by using an electrocautery surgical device to cut and coagulate human breast tissues. Airborne particle number concentration and particle distribution were determined by direct reading instruments. Airborne concentration of selected volatile organic compounds (VOCs) were determined by evacuated canisters. Head space analysis was conducted to quantify dissolved VOCs in cell culture medium. Human small airway epithelial cells (SAEC) and RAW 264.7 mouse macrophages (RAW) were exposed to surgical smoke in culture media for 24 h and then assayed for cell viability, lactate dehydrogenase (LDH) and superoxide production.ResultsOur results demonstrated that surgical smoke-generated from human breast tissues induced cytotoxicity and LDH increases in both the SAEC and RAW. However, surgical smoke did not induce superoxide production in the SAEC or RAW.Conclusion These data suggest that the surgical smoke is cytotoxic in vitro and support the previously published data that the surgical smoke may be an occupational hazard to healthcare workers.
Highlights
Operating room personnel have the potential to be exposed to surgical smoke, the by-product of using electrocautery or laser surgical device, on a daily basis
The smoke was collected with three autoclaved BioSamplers® (SKC Inc., Eighty Four, PA, USA) for each generation and each sampler was loaded with 2 mL of cell medium, either Dulbecco’s Modified Eagle Medium (DMEM) or Small Airway Epithelial Cell growth medium (SABM)
A total of 33 samples, and 39 samples, were collected using BioSamplers® loaded with DMEM and SABM, respectively, along with 33 background samples and 11 field blank samples
Summary
Operating room personnel have the potential to be exposed to surgical smoke, the by-product of using electrocautery or laser surgical device, on a daily basis. Electrocautery, laser ablation, and ultrasonic scalpel dissection are widely recognized as major advances in surgical technique and are increasingly being used for tissue cutting and hemostasis [2]. Surgical incision and dissection with electrocautery, laser and ultrasonic scalpel are used to cut tissue and decrease bleeding through coagulating small blood vessels. The breakdown of cellular membranes and other tissue structures generates many biological by-products that. Ultrafine particles in the surgical smoke have the ability to reach the alveolar region of the lung and cause pulmonary inflammation or disease [22, 23]
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