Paroxysmal fumes during surgical operations endanger the health of medical staff. Special measures for removing surgical smoke are lacking. Article Real-time monitoring of particulate matter concentrations in surgical smoke at different locations under different surgical conditions were explored, and a particulate matter purification control strategy was proposed. The PM2.5 and PM10 concentrations in the operating and respiratory zones near the operating table were about 3.0 times more than the specified value, but both surgical procedures met the requirements of PM concentration in the public zone. Therefore, a clean operating room is not clean for medical staff. The smoke produced by the three scalpels resulted in particle sizes of 0.30-2.50 μm in the respiratory zone, and calculate apparent density of powders to be 1.21g cm-3. The surgical smoke produced by the ultrasound scalpel resulted in the highest median PM10 concentration in the operating area. The results show that the smoke produced by different surgical conditions is mainly ultra-fine particles, which are more likely to harm the health of medical staff. A small surgical smoke circulation purification and dust removal system was designed, which could effectively suppress the spread of surgical smoke and reduce the occupational hazards of medical staff. The optimized control plan could significantly reduce the PM2.5 concentration value at measurement point a when the electric knife was turned on by approximately 200.0 %. The PM2.5 concentration of breathing zone was close to 75.0 μg m-3 , which basically met the occupational health requirements. The decrease in the PM2.5 concentration of operating zone was about 50.0 %, but it still exceeded the limit. It had a reference value for the occupational health protection of the firstline medical staff of existing epidemics.