dangers of smoke plume (surgical smoke)

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HAVE YOU CONSIDERED THE

DANGERS OF SURGICAL SMOKE

PLUME ?

“The mutagenic effect created by thermal destruction of 1 g of tissue is equivalent to that of three or six cigarettes for laser and electrocautery smoke, respectively.”

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THE FACTS

Surgical Smoke is an unwanted part of every electrosurgery and laser procedure. Not only is the lingering odour of surgical smoke unpleasant, but the repeated exposure to the smoke plume presents a potential danger to both perioperative staff and patients. Over recent years, medical professionals have become aware of the dangerous exposure to viruses. The potential risks include pulmonary irritation and inflammation, transmission of infections and viruses. Viable particles (i.e. cellular elements and erythrocytes) have been found in plumes, reinforcing their infectious potential.

The National Association of Theatre Nurses (NATN) standards report states that:

• All thermal instruments used in

surgery produce smoke which potentially contains infective agents that may be hazardous to staff.

• There is evidence to suggest

that the content of this plume could contain toxic chemicals, carbonised tissue, blood particles, viral DNA particles, bacteria and carbon dioxide, to name but a few.

This part of the booklet outlines the risks of surgical smoke plume and suggests

ways that you can protect your patients and your own health. The rest of the booklet is made up of clinical papers to support the need for you to invest in a smoke evacuation system. WHAT IS IN SURGICAL SMOKE PLUME? Chemicals such as benzene, formaldehyde, acrolein, CO and hydrogen cyanide have been found in the plume generated by tissue ablation. Smoke plume is well known to contain carcinogens, mutagens, irritants, and fine dusts. Plumes may also contain bio aerosols, viruses and cancer cells, blood fragments, and bacteria spores. They also contain carbon monoxide, polyaromatic hydrocarbons, and various toxic gases. BLOOD- BORNE PATHOGENS EVIDENT IN SMOKE PLUME INCLUDE: HPV- Human Papilloma Virus and DNA are dispersed by laser and electrosurgical

“The mutagenic effect

created by thermal

destruction of 1 g of

tissue is equivalent to

that of three or six

cigarettes for laser and

electrocautery smoke,

respectively.” (W.L.

Barrett, Surgical smoke:

a review of the literature,

Surgical Endoscopy 17

(2003), pp. 979–987).

Surgical smoke plume is carcinogenic. You can protect your staff and patients from the risks.



treatment of infected patients. The material settles slowly and may infect nasal and respiratory epithelia. Hepatitis B – Hepatitis B has been demonstrated in laser plume. It remains intact in the blood aerosol. HIV – Viable virus and DNA have been demonstrated in blood aerosol and has been present in smoke evacuation hoses.

RECOMMENDATIONS There are ways to reduce the threat that smoke plume poses on your health and on the health of your patients. The NATN recommendations are as follows:

• “Dedicated smoke evacuators must be used and the filters checked and changed…”

• Piped or free standing suction units must not be used for smoke evacuation as they do not have particulate filters.

• High filtration face masks should be worn to minimise the inhalation of carbonaceous particles.

Traditional surgical masks are virtually ineffective as a precaution against inhaling the minute particulate matter in the surgical smoke1

. This is due to the micron size of the particulate and bacterial material present in the smoke plume. The particles are simply too

1 Clinical Laser Monthly p.101 September 1987

small and will not be filtered by a surgical mask. These airborne particles are small enough to penetrate deep within the respiratory tract. Associated risks from inhalation of these particles include airway inflammation, coughing, headaches, nausea, hepatitis, asthma, chronic bronchitis, carcinoma, emphysema, and HIV. Therefore, a smoke evacuation system

must have a sub micron filtration capability to filter the minute particles.

“Electrosurgery is one of the most commonly

used energy systems in laparoscopic surgery.

The burning of proteins and lipids produces a

noxious odour noticeable in the operating

room. In addition to possible long-term

effects, these chemicals may cause

headaches, irritation and soreness of the

eyes, nose and throat.” (M.P. Wu and Y.T

Ernest, Complications and Recommended

practices for electrosurgery in laparoscopy,

The findings published in DHHS National Institute for Occupational Safety and Health US (NIOSH) PUBLICATION NO. 96-128 warn that: “…this smoke plume can contain toxic gases and vapours such as benzene, hydrogen cyanide, formaldehyde, bio aerosols, dead and live cellular material (including blood fragments) and viruses.”



REFRENCES ON REQUEST



THE SOLUTION

THE PLUMESAFE TURBO AUTO-SENSE FEATURES ENHANCED WHISPER-QUIET TECHNOLOGY, TURBO SUCTION POWER, AND A NEW LCD SCREEN. THE NEW INTERACTIVE DISPLAY SCREEN PROVIDES A CLEAR VISUAL READOUT REGARDING EXACT FILTER TIME REMAINING, SUCTION RATE, MODE, AND FILTER TYPE.

Acu Evac II - an advanced, patented, high efficiency filtration system for eliminating surgical smoke plume which may contain hazardous bio-aerosols, live and dead cellular matter (including blood fragments & viruses). Surgical smoke plume can also be carcinogenic, which is another key reason to invest in the Acu-Evac to protect patients and staff.


dangers of smoke plume (surgical smoke)

Health & Medicine