Electrosurgery smoke: hazards and protection

Early discussion regarding smoke produced by both surgical lasers and electrosurgical machines concluded that the smoke produced by these instruments was little more than a malodorous nuisance. Animal and human studies to date, however, have suggested that this smoke is, indeed, dangerous. This smoke has been shown to be mutagenic and can contain bacteria and viruses, the HIV virus being the most notable. Furthermore, these particles are small enough to penetrate deep within the respiratory tract. In response to the concerns raised by these hazards, commercial smoke evacuation systems have been designed to greatly reduce the number of hazardous particles, as well as the noxious odor produced by electrosurgery and laser surgery. The efficacy of these systems, however, is dependent o n usage and placement close to the surgical site. This review paper presents the potential hazards of electrosurgical smoke, along with some guidelines on how to properly protect hospital staff and patients from these hazards.