The Pros And Cons Of Surgical Smoke

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THE COMPOSITION OF SURGICAL SMOKE AND AEROSOL The generation of surgical smoke by electrocautery and laser systems occur from the thermal action on the tissue and even though the energy source can differ the qualities of the smoke produced by these two methods are very similar (Alp et al., 2006). When a “hot” tool, such as a laser or electrosurgery device, is used to vaporize, cut, ablate, excise, or coagulate tissue surgical smoke is produced.(Baggish et al., 1988) This smoke contains three primary components. The first is particulate matter which consists of the carbonised tissue, blood, and potentially infectious viruses and bacteria. The second is steam, this accounts for 95% of the smoke. The third component is the various toxins or potentially hazardous chemicals, these can include irritant, carcinogenic and neurotoxic compounds (Al Sahaf et al., 2007) Studies carried out by (Ott, 1993) identified the following toxic chemical by products in surgical smoke: acrolein, isobutene, acetonitrile, methane, acrylonitrile, phenol, acetylene, polycyclic aromatic hydrocarbons, alkyl benzenes, propene, benzene, propylene, butadiene, pyridine, butane, pyrrole, carbon monoxide, styrene, creosols, toluene, ethane, xylene, ethylene, formaldehyde, free radicals and hydrogen cyanide. Al Sahaf et al. (2006) concurred with these findings and found that the smoke created with laser and electrocautery contains mainly hydrocarbons, nitriles, fatty acids and phenols. Of these they found formaldehyde, acrolein, mixtures of benzene, toluene, ethylbenzene, xylene and polyaromatic hydrocarbons to be of most concern. The presence of chemical toxins may result in pulmonary irritation and inflammation of the respiratory tract (Wenig et al., 1993) In ... ... middle of paper ... ... and colleagues concurred with the earlier findings of Garden et al. They identified human papilloma virus in the plume generated during loop electrosurgical procedure of the cervix. However, it remains unknown whether this DNA is in a viable form or not and this study recommended that future studies should focus on assessing the viability of the cells and the DNA in the plume generated by LEEP and also advocated the long term follow up of gynaecological surgeons involved with LEEP to help establish the consequences of exposure to this plume. However, in view of the presence of DNA in the plume they felt it would prudent to use smoke evacuation during these procedures (Sood et al. 1994). Sawchuck et al. 1989 also determined that viral DNA was present in the smoke produced when treating infectious papillomavirus. However they did not determine if it was infectious.

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