State of the Science: A Concept Analysis of Surgical Smoke

Surgical smoke has not been clearly defined in the literature and often is identified using surrogate terms (eg, plume). In January 2020, a literature search was performed and a principle-based concept analysis involving four general principles (epistemological, pragmatic, linguistic, and logical) was used to define surgical smoke and identify implications for perioperative personnel, patients, researchers, and policymakers. Surgical smoke is a visible plume of aerosolized combustion byproducts produced by heat-generating surgical instruments. It consists of water vapor and gaseous substances; can carry toxic chemicals, bacteria, viruses, and tumors; can obscure the surgical field; and can be inhaled. Surgical smoke has a distinctive noxious odor and can cause physical symptoms such as watery eyes and throat irritation. Perioperative leaders should promote protection from occupational harm by educating their staff members on the use of smoke evacuators to mitigate the effects of surgical smoke on perioperative patients and personnel.