Qualitative analysis of surgical smoke produced during burn operations

Burned tissue is necrotic and it is surrounded by a zone of stasis and hyperaemia with changed cell metabolism. The removal of burned tissue using an electric knife releases large amounts of surgical smoke. The aim of the research was to analyse volatile, nonpolar, organic compounds that are released during the excision of burned tissue using an electric knife (mono- and bipolar). The study includes analysis from 40 solid-phase microextraction (SPME) fibres, exposed during 10 interventions (6 escharotomy and 4 necrectomy). The analysis of volatile compounds was performed using mass spectrometry gas chromatography (GCxGC-ToFMS).The total analysis covered 432 compounds, whereas after the removal of the "background" compounds - 153 volatile organic substances remained. The analysis of surgical smoke showed that, including derivatives, benzene constituted as much as 17.65% of all of the studied compounds. Cyclic compounds constituted on average 22.5% of the analysed substances, out of which cycloheptatrien constituted 20.26%. Alkanes, alcohols and their derivatives constituted nearly 25% of volatile organic compounds, with chloromethane constituting as much as 13.7%. Permutational multivariate analysis of variance (PERMANOVA) revealed statistically significant differences between escharotomy and necrectomy patients (F(1.9) = 5.91, p = 0.007).Our study revealed the presence of complex toxic hydrocarbon derivatives in surgical smoke. We also observed that the content of surgical smoke is different depending on the type of the conducted intervention. So far, no studies focusing on hazards posed by surgical smoke that is released during the resection of burned tissue are in the literature.