Plume Generated by Different Electrosurgical Techniques: An In Vitro Experiment on Human Skin

Area of Science:

• Dermatologic Surgery
• Surgical Technology
• Aerosol Science

Background:

• Surgical plume from electrosurgical devices presents a significant health hazard to patients and healthcare professionals.
• Understanding the particle generation of different energy devices is crucial for mitigating risks.

Purpose of the Study:

• To compare particle concentrations generated by various energy devices used in dermatologic surgery.
• To identify safer electrosurgical techniques based on particulate matter output.

Main Methods:

• Five electrosurgical techniques were tested on human tissue samples within a controlled, closed chamber.
• A particle counter measured aerosolized particle concentrations across seven size ranges (0.3–10 μm) at a fixed distance.

Main Results:

• Monopolar electrocoagulation generated the highest particle concentration, followed by electrocautery, electrodesiccation, and electrofulguration.
• Bipolar electrocoagulation produced substantially lower concentrations of fine particles (0.3 and 0.5 μm) compared to monopolar electrocoagulation.
• The smallest particle sizes (0.3 and 0.5 μm) were most abundant across all tested electrosurgical methods.

Conclusions:

• Bipolar electrocoagulation is the safest electrosurgical technique, generating the least particulate matter.
• The use of bipolar forceps offers a safer alternative for electrical surgery, protecting both surgical staff and patients from hazardous plume.