A Retrospective Study on the Hazards of the Carbon Dioxide Laser Plume

Abstract

Recent experimental studies of airborne contaminants found in the carbon dioxide laser plume have raised questions as to the potential danger of serious viral transmission during laser procedures. These concerns originated from a study of the human papilloma wart virus that reported intact strands of the DNA virus in the laser plume during the ablation of verrucae with the carbon dioxide laser. However, the study did not demonstrate the viability of such viral remnants. Such viability is difficult to demonstrate due to the strict species specificity of the papilloma virus, thus precluding the possibility of transinfection of an animal model with human papilloma DNA. We have therefore conducted a retrospective study to explore both the incidence of acquired lesions among laser users and also the details predisposing to the development of such lesions. Although a small percentage of our respondents reported acquired lesions, the role of the laser plume as the primary source of such lesions is unlikely. It is our opinion that the majority of reported lesions were acquired through direct contact, and proper sterile technique would significantly reduce the transmission of human papilloma virus during therapeutic procedures.

Surgical smoke: a review of the literature

“…An earlier study showed a transmission rate of 3.2%. Some of the infections most likely were due to patient-to-doctor contact, but none of the infections were manifest on the buccal mucosa or larynx, suggesting that direct contact was the route of transmission [47].…”

Viral Disease Transmitted by Laser-Generated Plume (Aerosol)

“…Also, clinical surveys of laser users have revealed increased user infections with HPV; however, direct lesional contact may be the source of infectivity. [12][13][14] Intact papillomavirus DNA is a potential infectious agent. [15][16][17] Although in vitro methods have detected liberated infective virus in the collected plume, in the papillomavirus 6 and the human immunodeficiency virus 11 models using the CO 2 laser, and in an in vitro study 18 of erbium (ER):YAG laser-generated aerosol, STUDY the induction of actual infection by the laser plume, to our knowledge, has not been documented.…”

Surgical smoke and the dermatologist

“…In the next few years two clinical surveys of laser users revealed increased infections with HPV. 26,27 In 1995, Gloster and Roenigk 5 at the Mayo Clinic conducted a comparative study using questionnaires sent to members of the American Society for Laser Surgeons and the American Society of Dermatologic Surgery. The comparison groups were CO 2 laser surgeons and two large groups of patients in the community with a diagnosis of warts.…”