Hazards of surgical smoke from electrocautery: A critical review of the data

Am J Surg. 2024 Feb 9:S0002-9610(24)00107-7. doi: 10.1016/j.amjsurg.2024.02.017. Online ahead of print.

Abstract

Introduction: Concerns have been voiced regarding the possibility of health risks to the operating room personnel from exposure to surgical smoke generated from electrocautery.

Methods: Ovid Medline was queried using search terms "surgical smoke", "electrosurgery," "smoke evacuator". The NIOSH Health Hazard Evaluations Database was searched using terms, "hospital", "operating room", "Ames", "mutagen", and "salmonella".

Results: Levels of pollutants in the breathable airspace within the operating room have been repeatedly shown to be very low. Absolute counts of particulate matter in the operating room are low when compared to other environments. The possibility for virus transmission with electrocautery in the operating room is unknown.

Conclusions: The risks related to the exposure to electrocautery surgical smoke have been overstated. Rigid mandates requiring smoke evacuators in all situations are not justified at this time.

Publication types

  • Review