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Volume 32, Issue 4, Pages 253-257 (October 2009)


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Surgical Smoke

Joe King-Man Fan, Fion Siu-Yin Chan, Kent-Man ChuCorresponding Author Informationemail address

Accepted 24 August 2009.

Surgical smoke is the gaseous by-product formed during surgical procedures. Most surgeons, operating theatre staff and administrators are unaware of its potential health risks. Surgical smoke is produced by various surgical instruments including those used in electrocautery, lasers, ultrasonic scalpels, high speed drills, burrs and saws. The potential risks include carbon monoxide toxicity to the patient undergoing a laparoscopic operation, pulmonary fibrosis induced by non-viable particles, and transmission of infectious diseases like human papilloma virus. Cytotoxicity and mutagenicity are other concerns. Minimisation of the production of surgical smoke and modification of any evacuation systems are possible solutions. In general, a surgical mask can provide more than 90% protection to exposure to surgical smoke; however, in most circumstances it cannot provide air-tight protection to the user. An at least N95 grade or equivalent respirator offers the best protection against surgical smoke, but whether such protection is necessary is currently unknown.

Key Words aerosol , cautery , respirator , toxicity

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Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR

Corresponding Author InformationAddress correspondence and reprint requests to Professor Kent-Man Chu, Chief, Division of Upper Gastrointestinal Surgery, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong SAR

PII: S1015-9584(09)60403-6

doi:10.1016/S1015-9584(09)60403-6


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