Surgical_smoke
Surgical smoke is the by-product produced by electrosurgery, laser tissue ablation, or other surgical techniques. Surgical smoke, as a health threat to those exposed to it, has become a growing concern.[1] Studies have demonstrated, depending on several factors, it may contain carcinogens, mutagens, irritant chemicals, live viruses and bacteria, and viable malignant cells. [1][2][3] These all pose a theoretical and demonstrable risk of harming patients or operating room personnel upon exposure.[3] Other names for surgical smoke are cautery smoke, plume, diathermy plume, or, sometimes, aerosols produced during surgery, vapor contaminants, or air contaminants.[4]
Electrosurgery and laser ablation are the most common sources of surgical smoke.[3] Heat generated during surgery causes cell membranes to heat and rupture, releasing cellular debris alongside water vapor.[3] Surgical smoke is composed of 95% water and the remaining 5% contains byproducts of combustion and cellular debris.[3] The negative health effects due to exposure of surgical smoke is attributed to what is contained in the 5%.[3] The size of particles within the plume of smoke varies depending on the device that generated it.[3] On average electrosurgery produces particles that are .07 μm, while laser ablation generates larger particles that are .31 μm on average.[3][5] Particles smaller than 2 micrometers are able to reach the alveoli within the lower respiratory tract and, if 0.1 μm or smaller, can enter systemic circulation.[3][5]
The amount of cellular debris in a smoke plume changes with the tissue being cauterized. The liver has been shown to generate the largest amount of particles.[3] Other than type of tissue and surgical device, operating room airflow can also affect smoke exposure.[5][3] read more on