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Clearing the air on surgical plume.
Watters, David A; Foran, Paula; McKinley, Sharryn; Campbell, Graeme.
  • Watters DA; Victorian Perioperative Consultative Council, Victoria, Australia.
  • Foran P; School of Medicine and Health Sciences, Deakin University, Geelong, Australia.
  • McKinley S; Department of Surgery, University Hospital Geelong, Barwon Health, Geelong, Australia.
  • Campbell G; Victorian Perioperative Consultative Council, Victoria, Australia.
ANZ J Surg ; 92(1-2): 57-61, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1494594
ABSTRACT

BACKGROUND:

Surgical smoke or plume is produced by a variety of surgical coagulators and dissectors. A number of jurisdictions have recently introduced policies to reduce the associated occupational health risks including WorkSafe Victoria and New South Wales Health.

METHOD:

This paper is a narrative review of potential risks, including any associated with COVID-19, and options for mitigation.

RESULTS:

Surgical smoke or plume contains potentially toxic chemicals, some of which are carcinogens. Plume may also contain live virus, notably Human Papilloma and Hepatitis B, though any possible viral transmission is limited to a few case reports. Despite identifying COVID-19 ribonucleic acid fragments in various body tissues and fluids there are no current reports of COVID-19 transmission. Although plume is rapidly removed from the atmosphere in modern operating rooms, it is still inhaled by the operative team. Mitigation should include ensuring diathermy devices have evacuators while plume extraction should be standard for laparoscopic procedures. Consideration needs to be given to the potential to compromise the operating field of view, or the noise of the extractor impairing communication. There is an increasing range of suitable products on the market. The future includes pendant systems built into the operating room.

CONCLUSION:

The potential risks associated with surgical plume cannot be ignored. Health services should invest in plume extraction devices with a view to protecting their staff. The conduct of the operation should not be compromised by the devices chosen. Future operating theatres need to be designed to minimize exposure to plume.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Occupational Exposure / COVID-19 Type of study: Observational study / Prognostic study / Reviews Limits: Humans Language: English Journal: ANZ J Surg Year: 2022 Document Type: Article Affiliation country: Ans.17340

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Occupational Exposure / COVID-19 Type of study: Observational study / Prognostic study / Reviews Limits: Humans Language: English Journal: ANZ J Surg Year: 2022 Document Type: Article Affiliation country: Ans.17340