The smell of surgical plume is unmistakable, and so are the potential risks of inhaling it. As soon as particulate wafts into the OR air, your surgeons and staff are at increased risk of relatively minor skin and eye irritations, serious long-term respiratory issues or, worse, contracting a debilitating viral disease. Take ownership in your personal safety by understanding the true dangers of surgical plume and protecting yourself from the risk of exposure.
There are several potential hazards associated with surgical smoke: blood fragments, viable bloodborne pathogens, bacteria and viruses, gases and vapors, and lung-damaging dust. Some of the gases have demonstrated carcinogenic and mutagenic potential.1,2
Particulate matter generated during surgical procedures is dependent upon instrumentation and can range in size from 0.07 to 6.5 micrometers.3,4 Acute and chronic respiratory conditions, like asthma, bronchitis and emphysema, are associated with the inhalation of particles smaller than 5 micrometers.3 Surgical smoke can also have strong odors that can lead to headaches and irritation of the eyes, nose and throat.
It has been demonstrated that 1 gram of tissue irradiated with a CO2 laser releases smoke that has the mutagenic potential of 3 unfiltered cigarettes.5 This statistic gets cited often, but has not been replicated. It would be beneficial if studies were conducted to see if the same level of mutagenicity is measured in smoke generated with devices used in the OR today.
Research experiments have shown that HIV and hepatitis can remain viable in surgical smoke.3,6 Case studies have demonstrated viral transmission of HPV from patients with anogenital condylomas to surgical team members in the OR. The impacted healthcare workers developed laryngeal papillomatosis.7,8
Smoke evacuation is also a patient safety issue. It's been shown that carbon monoxide is produced during laparoscopic procedures. The carbon monoxide that's absorbed by patients increases post-operative peripheral blood carboxyhemoglobin levels and intra-abdominal carbon monoxide concentrations. Elevated carboxyhemoglobin at sufficient levels can result in nausea, headaches, dizziness and weakness.9 The same research demonstrating the viability of HIV in surgical plume also demonstrated that the virus remained viable for up to 2 weeks.6 Implementing smoke evacuation devices limits the amount of smoke that settles into the body cavity during surgical procedures and reduces the risk of disease transmission.