Investigating surgical smoke in otolaryngology operating rooms

Chun-I. Li,Ying-Hsiang Chou,Chih-Hsuan Chen,Jar-Yuan Pai,Min-Chi Chiang

doi:10.1038/s41598-022-05701-1

Abstract

Surgical smoke is a common chemical hazard produced from the use of electrocautery, laser, or ultrasonic scalpels during surgery. It has been proved harmful to medical personnel. Thus, it is important to monitor surgical smoke concentrations in the operating room. In the past decade, many researches regarding surgical smoke were discussed in different professional healthcare fields, but few showed the correlation between surgical smoke and otolaryngology surgery. In this study, the concentrations of particulate matter and formaldehyde were measured during thirty cases of several types of otolaryngology surgery in a regional research hospital in Taiwan. The concentrations of 0.3 µm and 0.5 µm particulate matter raised rapidly in the main knife range at the beginning of the electrocautery knife used, and then decreased by half after 5–10 min of use. The concentrations of formaldehyde were ranged from 1 to 2 ppm during the surgery, which is higher than the permissible exposure limit. While many medical staffs are working in the operating room and are exposed to the smoke hazard, effective strategies for collecting and eliminating the smoke should be taken in all medical facilities.

Highlights

Surgical smoke is a common chemical hazard produced from the use of electrocautery, laser, or ultrasonic scalpels during surgery
In the operating room (OR), the average concentrations of particulate matter of size 0.3 μm and 0.5 μm reached their highest levels at the beginning of the electrocautery knife used at the main knife range
The increasing concentration of particulate matter while using electrocautery knives in the OR exposed the medical personnel to a high-risk environment

Summary

Introduction

Surgical smoke is a common chemical hazard produced from the use of electrocautery, laser, or ultrasonic scalpels during surgery. The concentrations of particulate matter and formaldehyde were measured during thirty cases of several types of otolaryngology surgery in a regional research hospital in Taiwan. Surgical smoke is one of the most common chemical hazards produced from the use of electrocautery, laser, or ultrasonic scalpels in the operating room (OR). Cheng et al concluded that the particle sizes of surgical smoke are less than 1 μm mostly, and the average aerodynamic diameter of PM generated by electrosurgical tools is about 0.07 μm[14] These hazardous substances can be inhaled and deposit on the upper respiratory tract, cause respiratory diseases like chronic obstructive pulmonary disease, asthma, bronchitis, and even lung c ancer[15]. Simple and effective methods were developed to exhaust smoke during surgical operations, such as using a synchronous smoke evacuator near the electric s calpel[18]

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