Surgical smoke and ultrafine particles

Brüske‐Hohlfeld, Irene; Preißler, Gerhard; Jauch, Karl‐Walter; Pitz, Mike; Nowak, Dennis; Peters, Annette; Wichmann, H‐Erich

doi:10.1186/1745-6673-3-31

Cited by 132 publications

(143 citation statements)

References 32 publications

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“…The size of such particles closely depends on the particular instruments used. Indeed, various investigations have revealed that the electrocautery releases the smallest particles, with a mean aerodynamic size of 0.07 µm, whereas laser tissue coagulation produces larger particles (0.31 µm) and the largest particles are generated by the ultrasonic scalpel (0.35–6.5 µm) [12].…”

Section: Discussionmentioning

confidence: 99%

Can Particulate Air Sampling Predict Microbial Load in Operating Theatres for Arthroplasty?

et al. 2012

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Several studies have proposed that the microbiological quality of the air in operating theatres be indirectly evaluated by means of particle counting, a technique derived from industrial clean-room technology standards, using airborne particle concentration as an index of microbial contamination. However, the relationship between particle counting and microbiological sampling has rarely been evaluated and demonstrated in operating theatres. The aim of the present study was to determine whether particle counting could predict microbiological contamination of the air in an operating theatre during 95 surgical arthroplasty procedures. This investigation was carried out over a period of three months in 2010 in an orthopedic operating theatre devoted exclusively to prosthetic surgery. During each procedure, the bacterial contamination of the air was determined by means of active sampling; at the same time, airborne particulate contamination was assessed throughout the entire procedure. On considering the total number of surgical operations, the mean value of the total bacterial load in the center of the operating theatre proved to be 35 CFU/m3; the mean particle count was 4,194,569 no./m3 for particles of diameter ≥0.5 µm and 13,519 no./m3 for particles of diameter ≥5 µm. No significant differences emerged between the median values of the airborne microbial load recorded during the two types of procedure monitored. Particulates with a diameter of ≥0.5 µm were detected in statistically higher concentrations (p<0.001) during knee-replacement procedures. By contrast, particulates with a diameter of ≥5 µm displayed a statistically higher concentration during hip-replacement procedures (p<0.05). The results did not reveal any statistically significant correlation between microbial loads and particle counts for either of the particle diameters considered (≥0.5 µm and ≥5 µm). Consequently, microbiological monitoring remains the most suitable method of evaluating the quality of air in operating theatres.

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Section: Discussionmentioning

confidence: 99%

Can Particulate Air Sampling Predict Microbial Load in Operating Theatres for Arthroplasty?

et al. 2012

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“…However, many of the tasks performed during the finishing stages of tunnel construction will be similar to the work carried out by tunnel rehabilitation workers. Exposure to ultrafine particles is documented in other industries and processes relevant to tunnel construction or rehabilitation, including welding,6–8 the rubber manufacturing industry,9 asphalt work,10 paving and related road construction operations,11 industrial plants,12 as well as other types of exposure such as cooking13–16 and surgical smoke exposure 17 18…”

Section: Introductionmentioning

confidence: 99%

“…Personal exposure, measured by sampling in the breathing zone, has been measured only in a few studies. These studies concern exposure to cooking fumes,13 16 exposure levels for airport employees,30 surgical smoke exposure,17 18 paving and road construction workers11 and welding 6 34. An overview of the results is presented in table 2.…”

Section: Introductionmentioning

confidence: 99%

Personal exposure to ultrafine particles from PVC welding and concrete work during tunnel rehabilitation

2016

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PVC welding in a vertical position resulted in very high exposure of the worker to ultrafine particles compared to other types of work tasks. In evaluations of worker exposure to ultrafine particles, it seems important to distinguish between personal samples taken in the breathing zone of the worker and more stationary work area measurements. There is a need for a portable particle-sizing instrument for measurements of ultrafine particles in working environments.

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“…Since the peritoneal cavity is inflated with carbon dioxide, surgical smoke, an unwanted by product of coagulation, is formed in an oxygen-free atmosphere [1]. As a result of pyrolysis a number of chemical substances, which are known to have a toxic effect on the human body, are formed.…”

Section: Introductionmentioning

confidence: 99%

Health risk to medical personnel of surgical smoke produced during laparoscopic surgery

Dobrogowski

Wesołowski²,

Kucharska³

et al. 2015

Int J Occup Med Environ Health

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Objectives: During laparoscopic cholecystectomy, the removal of the gall bladder, pyrolysis occurs in the peritoneal cavity. Chemical substances which are formed during this process escape into the operating room through trocars in the form of surgical smoke. The aim of this study was to identify and quantitatively measure a number of selected chemical substances found in surgical smoke and to assess the risk they carry to medical personnel. Material and Methods: The study was performed at the Maria Skłodowska-Curie Memorial Provincial Specialist Hospital in Zgierz between 2011 and 2013. Air samples were collected in the operating room during laparoscopic cholecystectomy. Results: A complete qualitative and quantitative analysis of the air samples showed a number of chemical substances present, such as aldehydes, benzene, toluene, ethylbenzene, xylene, ozone, dioxins and others. Conclusions: The concentrations of these substances were much lower than the hygienic standards allowed by the European Union Maximum Acceptable Concentration (MAC). The calculated risk of developing cancer as a result of exposure to surgical smoke during laparoscopic cholecystectomy is negligible. Yet it should be kept in mind that repeated exposure to a cocktail of these substances increases the possibility of developing adverse effects. Many of these compounds are toxic, and may possibly be carcinogenic, mutagenic or genotoxic. Therefore, it is necessary to remove surgical smoke from the operating room in order to protect medical personnel.

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Surgical smoke and ultrafine particles

Abstract: Background: Electrocautery, laser tissue ablation, and ultrasonic scalpel tissue dissection all generate a 'surgical smoke' containing ultrafine (<100 nm) and accumulation mode particles (< 1 μm). Epidemiological and toxicological studies have shown that exposure to particulate air

Cited by 132 publications

References 32 publications

Can Particulate Air Sampling Predict Microbial Load in Operating Theatres for Arthroplasty?

Can Particulate Air Sampling Predict Microbial Load in Operating Theatres for Arthroplasty?

Personal exposure to ultrafine particles from PVC welding and concrete work during tunnel rehabilitation

Health risk to medical personnel of surgical smoke produced during laparoscopic surgery

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