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Surgical smoke

Surgical smoke, also known as surgical plume, is a by-product from the use of any heat generating instruments when cutting, vaporizing, or coagulating tissue during surgical procedures.

This heat causes cell membranes to heat and rupture, releasing cellular debris alongside water vapor. Surgical smoke is composed of 95% water with the remaining 5% contains by products of combustion and cellular debris, including chemicals, blood and tissue particles, bacteria, and viruses. These by-products from surgical smoke have been shown to exhibit potential health risks for surgeons, nurses, anesthesiologists, and technicians in the operation room due to long term exposure of smoke1).

Today it is also well-recognised that surgical smoke is comparable with cigarette smoke. Researchers have found the amount of surgical smoke produced daily in a plastic surgery operating theater was equivalent to inhaling smoke from 27 to 30 unfiltered cigarettes2). Furthermore, surgical smoke can contain more than 150 hazardous chemicals, whereas 40 of these are carcinogenic such as benzene, hydrogen cyanide, and formaldehyde3).

30

One day’s exposure to surgical smoke is equivalent to smoking 27 to 30 unfiltered cigarettes

150

Hazardous chemicals are found in surgical smoke, including benzene and formaldehyd

2x

Perioperative nurses have twice the incidence of many respiratory problems as compared to the general population

Not only is surgical smoke a nuisance because it has an unpleasant odor and can obstruct the surgeon’s view of the surgical site, but it has also been well documented that transmission of e.g. human papillomavirus (HPV) through surgical smoke is a risk to healthcare workers in the operating theatre4). Additionally, perioperative nurses report twice the incidence of many respiratory problems compared to the general population5). At CIMPAX, we believe that it is a human right, also for members of the operating room (OR), to have a healthy and safe work environment. Therefore, it is our mission to educate the OR staff to be well protected from the hazards associated with the daily exposure to surgical smoke by implementing a strong policy and an effective smoke evacuation solution.

Sources: 1. Liu Y, Song Y, Hu X, Yan L, Zhu X (2019). “Awareness of surgical smoke hazards and enhancement of surgical smoke prevention among the gynecologists”. Journal of Cancer. 10 (12): 2788–2799. doi:10.7150/jca.31464. PMC 6584931. PMID 31258787. 2. Hill DS, O’Neill JK, Powell RJ, Oliver DW. Surgical smoke – a health hazard in the operating theatre: a study to quantify exposure and a survey of the use of smoke extractor systems in UK plastic surgery units. J Plast Reconstr Aesthet Surg. 2012;65(7):911-916. 3. Barrett WL, Garber SM. Surgical Smoke: A review of the literature. Is this just a lot of hot air? Surg Endosc. 2003;17(6):979-87 4. Rioux et al. Journal of Otolaryngology – Head and Neck Surgery 2013, 42:54 – http://www.journalotohns.com/content/42/1/54. 5. Ball K. Compliance with surgical smoke evacuation guidelines: implications for practice. ORNAC J.2012;30(1):14-16. [IIIB]

The amount of surgical smoke produced daily in a plastic surgery operating theater is equivalent to inhaling smoke of

27 to 30 unfiltered cigarettes