Chemical composition and potential hazards of electrocautery smoke

Abstract

Electrocautery is widely used for dissection of tissues and cauterization of blood vessels. A visible plume of smoke is produced, which has an unpleasant odour and can induce acute and chronic inflammatory changes in the respiratory tract'. Airborne particles arc not effectively filtered or evacuated by operating room scavenging systems and facial masks only offer protection from large particles. Little is known about the chemical composition of this smoke and the health risks to the operating room staff have not been identified. The aim of this study was to determine the chemical composition of electrocautery smoke produced in the course of standard colorectal surgery.

Is It Time for a More Systematic Approach to the Hazards of Surgical Smoke?: Reconsidering the Evidence

“…Surgical smoke has mutagenic effects (Gatti, Bryant, Noone, & Murphy, 1992). Specific chemicals contain respiratory irritants (Al Sahaf, Vega-Carrascal, Cunningham, McGrath, & Bloomfield, 2007;Sagar, Meagher, Sobczak, & Wolff, 1996), carcinogens (Krones et al, 2007), and teratogens (Wu et al, 2011), affecting bone marrow and cellular and nutritional metabolism (Krones et al, 2007). It is well established that the chemical composition of surgical smoke varies by the type of tissue dissected.…”

“…The most significant independent variable and variance was due to the number of personnel in the OR. Sagar, et al 1996 Smoke was captured at the point of origin during 6 bowel resections. Pilot study.…”

Cambios en la mucosa nasal de los médicos por exposición al humo por electrocoagulación

“…El humo del cauterio producido en los procesos de electrocoagulación es visible; sin embargo, no se ha dimensionado su capacidad de producir daño con base en su composición química y biológica, dado que esta potencialidad no ha sido calculada, además de que no existe mucha información hasta este momento que indique el daño en la mucosa nasal producido por dicha exposición [5,9,10].…”

Operating room nursing and lung cancer risk in a cohort of female registered nurses

“…Laser surgery and electrocautery generate a visible, acrid smoke that contains numerous chemicals, including respiratory irritants and known and potential human carcinogens (1)(2)(3). These surgical procedures are in widespread use in operating and medical examination rooms, and knowledge of the chemical composition of surgical smoke has led to concern over the potential long-term occupational health hazards of exposure to surgical smoke.…”

“…On the basis of an in vitro assay, Tomita et al (16) estimated that the smoke produced during laser irradiation or electrocauterization of 1 gram of tissue is equivalent to three to six cigarettes in mutagenic potential. Potentially harmful chemical compounds identified in surgical smoke include benzene, formaldehyde, toluene, acrolein, and polycyclic aromatic hydrocarbons (PAH) (1,3). Although the results of laboratory and animal studies suggest the possibility that repeated exposure to surgical smoke may cause pulmonary problems in humans, no population-based studies of the health effects of long-term surgical smoke exposure have been published.…”