Ten questions concerning particle exposure in open electrosurgery and its control strategies

Abstract

The increasing use of high-frequency electrosurgical pencils in open surgeries has heightened concerns about the adverse implications of electrosurgical smoke (ES) on perioperative personnel. Since 2015, there has been an increasing amount of research on electrosurgical smoke particles annually. Despite data discrepancies, nanoparticles (core particle size <200 nm) generally dominate in number distributions. Particulate matter (PM) concentration is closely related to the type of target tissue. Most studies show that ultrafine particle (UFP) concentrations near the main surgeon’s breathing zone inversely correlate with operating room air changes and positively correlate with the power of the electrosurgical pencil. Local smoke evacuation devices with negative ions, specialized filters and N95 respirators are more effective in protecting perioperative staff health, particularly against UFPs. The objective is to summarize particle exposure knowledge in open electrosurgery and establish a research agenda to protect medical personnel from ES exposure.