This article appears in the January/February print issue of Surgical Products.

The healthcare industry’s stance on surgical smoke in the operating room has evolved considerably over the course of the past several years. As more information came out about the potential dangers of surgical smoke in the operating room, the healthcare industry responded by actively seeking out and implementing products and solutions to address those possible threats. At the same time, the stance that it was harmful and should be dealt with became much more prevalent throughout the industry.

“Everyone was aware of the smoke, but they didn’t know if it was harmful or not,” says Richard Fleenor, President and CEO of Pare Surgical. “I remember back in the 1980s, the thought was that (the smoke) had some stuff in it, but we didn’t know if it’s really that harmful. The plum is mostly water, but the rest is what everyone’s concerned about now. That data has all come out in the past 10 or 15 years.”

The Center for Disease Control and Prevention maintains that surgical smoke is hazardous to the health of both patients and staff. Organizational studies found surgical smoke – in plume or aerosol form – can contain both toxic gases and vapors (including, but not limited to, benzene, hydrogen cyanide, formaldehyde, bioaerosols, dead and live cellular material, as well as viruses).

According to Sherri Lloyd, Product Marketing Manager, Buffalo Filter, concerted efforts to address surgical smoke commenced when the Association of PeriOperative Registered Nurses (AORN) hosted its first multidisciplinary roundtable discussion on surgical smoke in January of 1996. AORN made another push to raise awareness about the hazards of surgical smoke by hosting a second conference on surgical smoke in February of 1997. Those early discussions helped shape future guidelines and recommendations. Almost a decade later, in 2006, the United States Occupational Safety and Health Administration forged an alliance with AORN to deal with workplace safety issues. One of several issues the two organizations focused on was surgical smoke plume exposure due to the use of electrosurgery units and lasers during surgical procedures.

“Over the last seven years, the education and awareness of the hazards of surgical plume has increased as well as the push for corrective actions and policies,” says Lloyd.

These efforts have coincided with an increased use of ESUs and lasers in the operating room, which has led to greater exposure to surgical smoke plume generated by those devices.  Thankfully, while the healthcare industry has never been more aware of the potential consequences of surgical smoke, it also has never been better equipped to deal with them.

“With a massive education campaign and tools to help hospitals implement the procedure necessary to obtain a ‘Surgical Smoke Free Environment,’ there is now more awareness of the hazards of surgical plume and how it adversely impacts the OR staff,” states Lloyd. “Today more hospitals have developed policies that support a smoke-free environment, and we anticipate that this trend will continue.”

However, there is some question as to how surgical smoke evacuation products may evolve in the coming years to become even more effective at protecting healthcare professionals in the operating room.

“I’ve never seen a study of how much of the plume gets picked up and how much of it still goes out in the room,” says Fleenor. “But I think these suction systems are working relatively well. What you are doing is reducing the odds of something happening.”

The Pare Surgical President and CEO adds that there is only one way to fully protect against surgical smoke, but it is simply not a viable solution for operating room personnel.

“To be 100-percent safe, they would have to have a full body suit,” Fleenor says. “Anything less than that is going to expose their skin. And if you don’t have a respirator, you are still going to get something coming through the mask.”

And according to Lloyd, surgical smoke plume evacuation equipment is only one component of the overall effort to provide a safe operating room environment.

“We believe that educating key stakeholders about the inherent risks and hazards associated from plume exposure, and how to most effectively implement a program to manage these hazards while controlling costs is also paramount,” she says. “With the implementation of a successful smoke plume evacuation program we believe that operating room personnel will be protected from the hazards associated with surgical smoke plume.”

To subscribe to Surgical Products magazine, click here.