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Electrosurgical Smoke: Ultrafine Particle Measurements and Work Environment Quality in Different Operating Theatres

Author

Listed:
  • Francesco Romano

    (Politecnico di Milano, Dipartimento di Energia, via Lambruschini, 4, 20156 Milan, Italy)

  • Jan Gustén

    (Civil and Environmental Engineering/Building Services Engineering, Chalmers University of Technology, SE-41296 Gothenburg, Sweden)

  • Stefano De Antonellis

    (Politecnico di Milano, Dipartimento di Energia, via Lambruschini, 4, 20156 Milan, Italy)

  • Cesare M. Joppolo

    (Politecnico di Milano, Dipartimento di Energia, via Lambruschini, 4, 20156 Milan, Italy)

Abstract

Air cleanliness in operating theatres (OTs) is an important factor for preserving the health of both the patient and the medical staff. Particle contamination in OTs depends mainly on the surgery process, ventilation principle, personnel clothing systems and working routines. In many open surgical operations, electrosurgical tools (ESTs) are used for tissue cauterization. ESTs generate a significant airborne contamination, as surgical smoke. Surgical smoke is a work environment quality problem. Ordinary surgical masks and OT ventilation systems are inadequate to control this problem. This research work is based on numerous monitoring campaigns of ultrafine particle concentrations in OTs, equipped with upward displacement ventilation or with a downward unidirectional airflow system. Measurements performed during ten real surgeries highlight that the use of ESTs generates a quite sharp and relevant increase of particle concentration in the surgical area as well within the entire OT area. The measured contamination level in the OTs are linked to surgical operation, ventilation principle, and ESTs used. A better knowledge of airborne contamination is crucial for limiting the personnel’s exposure to surgical smoke. Research results highlight that downward unidirectional OTs can give better conditions for adequate ventilation and contaminant removal performances than OTs equipped with upward displacement ventilation systems.

Suggested Citation

  • Francesco Romano & Jan Gustén & Stefano De Antonellis & Cesare M. Joppolo, 2017. "Electrosurgical Smoke: Ultrafine Particle Measurements and Work Environment Quality in Different Operating Theatres," IJERPH, MDPI, vol. 14(2), pages 1-13, January.
    • Handle: RePEc:gam:jijerp:v:14:y:2017:i:2:p:137-:d:89114
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    Citations

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    Cited by:

    1. Marc Garbey & Guillaume Joerger & Shannon Furr, 2020. "A Systems Approach to Assess Transport and Diffusion of Hazardous Airborne Particles in a Large Surgical Suite: Potential Impacts on Viral Airborne Transmission," IJERPH, MDPI, vol. 17(15), pages 1-23, July.
    2. Marcelo Pereira & Arlindo Tribess & Giorgio Buonanno & Luca Stabile & Mauro Scungio & Ilaria Baffo, 2020. "Particle and Carbon Dioxide Concentration Levels in a Surgical Room Conditioned with a Window/Wall Air-Conditioning System," IJERPH, MDPI, vol. 17(4), pages 1-13, February.
    3. Francesco Romano & Samanta Milani & Jan Gustén & Cesare Maria Joppolo, 2020. "Surgical Smoke and Airborne Microbial Contamination in Operating Theatres: Influence of Ventilation and Surgical Phases," IJERPH, MDPI, vol. 17(15), pages 1-13, July.
    4. Marc Garbey & Guillaume Joerger & Shannon Furr, 2020. "Gastroenterology Procedures Generate Aerosols: An Air Quality Turnover Solution to Mitigate COVID-19’s Propagation Risk," IJERPH, MDPI, vol. 17(23), pages 1-17, November.
    5. Alessandra Cincinelli & Tania Martellini, 2017. "Indoor Air Quality and Health," IJERPH, MDPI, vol. 14(11), pages 1-5, October.
    6. Francesco Romano & Samanta Milani & Roberto Ricci & Cesare Maria Joppolo, 2020. "Operating Theatre Ventilation Systems and Their Performance in Contamination Control: “At Rest” and “In Operation” Particle and Microbial Measurements Made in an Italian Large and Multi-Year Inspectio," IJERPH, MDPI, vol. 17(19), pages 1-16, October.

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