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Surgical smoke control with local exhaust ventilation: Experimental study.
Taekhee Lee1, Jhy-Charm Soo1, Ryan F LeBouf2
1a Exposure Assessment Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health , Centers for Disease Control and Prevention , Morgantown , West Virginia.
Journal of Occupational and Environmental Hygiene
|December 29, 2017
Summary
Local exhaust ventilation (LEV) systems significantly reduce airborne particles and volatile organic compounds (VOCs) in surgical smoke. However, these systems do not completely eliminate contaminants, highlighting the need for continued safety measures in operating rooms.
Area of Science:
- Environmental Health
- Occupational Safety
- Surgical Technology
Background:
- Surgical smoke generated during electrosurgery contains potentially harmful airborne particles and volatile organic compounds (VOCs).
- Effective control of surgical smoke is crucial for maintaining a safe operating room environment for healthcare professionals.
Purpose of the Study:
- To evaluate the efficacy of local exhaust ventilation (LEV) systems in reducing airborne particulates and VOCs from surgical smoke.
- To compare the effectiveness of different LEV configurations, including a wall irrigation suction unit and a dedicated smoke evacuation system.
Main Methods:
- Surgical smoke was generated from human tissue using an electrocautery device in an unoccupied operating room.
- Three conditions were tested: no LEV, wall irrigation suction with a filter, and a smoke evacuation system.
- Particle concentrations (number and mass) were measured using multiple direct-reading instruments (CPC, DustTrak DRX, SMPS, APS).
- Volatile organic compounds (VOCs) were collected using evacuated canisters with various sampling techniques.
Main Results:
- The absence of LEV control resulted in the highest average concentrations of particles and VOCs.
- LEV systems significantly reduced particle concentrations, with reductions ranging from 61% to 86% compared to no LEV.
- Ethanol and isopropyl alcohol were the dominant VOCs detected; other VOCs were present at concentrations well below occupational exposure limits.
Conclusions:
- Local exhaust ventilation (LEV) systems are effective in substantially reducing airborne contaminants in surgical smoke.
- While LEV systems significantly decrease particle and VOC levels, they do not provide complete elimination.
- Further research may be needed to explore complementary strategies for comprehensive surgical smoke management.
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