Journal of the Formosan Medical Association
Volume 109, Issue 7 , Pages 511-516, July 2010

A Novel Inspection Protocol to Detect Volatile Compounds in Breast Surgery Electrocautery Smoke

  • Yu-Wen Lin

      Affiliations

    • Department of Public Health, College of Medicine, Fu Jen Catholic University, Taipei County, Taiwan
    • Yu-Wen Lin and Shou-Zen Fan contributed equally to this work.
    • ,
  • Shou-Zen Fan

      Affiliations

    • Department of Anesthesiology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei City, Taiwan
    • Yu-Wen Lin and Shou-Zen Fan contributed equally to this work.
    • ,
  • Kuo-Hui Chang

      Affiliations

    • Department of Public Health, College of Medicine, Fu Jen Catholic University, Taipei County, Taiwan
    • ,
  • Chiun-Sheng Huang

      Affiliations

    • Department of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei City, Taiwan
    • ,
  • Chin-Sheng Tang

      Affiliations

    • Department of Public Health, College of Medicine, Fu Jen Catholic University, Taipei County, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Chin-Sheng Tang, Department of Public Health, College of Medicine, Fu Jen Catholic University, 510 Jhongjheng Road, Sinjhuang City, Taipei County 24205, Taiwan

Received 22 April 2009; received in revised form 18 August 2009; accepted 16 October 2009.

Article Outline

Background/Purpose

Electrocautery procedures generate malodorous smoke. This study quantified five volatile organic compounds detected in the smoke produced during breast surgery, and elucidated the factors that affect their chemical production.

Methods

All samplers were assembled in an acrylic chamber with a Tygon tube attached to the tip of a diathermy pencil. The electrocautery smoke was quantified by gas chromatography/mass spectrometry.

Results

In all samples, toluene was identified in concentrations of 2.48–5.50 mg/m3. Higher concentrations were observed during modified radical mastectomy procedures. Patients with high body mass index revealed high toluene concentrations. Longer duration of electrocautery tended to produce more toluene.

Conclusion

The sampling protocol enabled acquisition of smoke samples near the source without interrupting surgery. The findings suggest that type of surgery, patient body mass index and duration of electrocautery are factors that can alter production of chemicals.

Key Words:  diathermy , surgical plume , volatile compounds

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Hollmann R , Hort CE , Kammer E , et al.   Smoke in the operating theater: an unregarded source of danger . Plast Reconstr Surg . 2004;114:458–463
  2. King B , McCullough J . NIOSH Health Hazard Evaluation Report 2000-0402-3021, Inova Fairfax Hospital, Falls Church, Virginia . USA: The National Institute for Occupational Safety and Health; 2006;
  3. King B , McCullough J . NIOSH Health Hazard Evaluation Report 2001-0030-3020, Carolina Medical Center, Charlotte, North Carolina . USA: The National Institute for Occupational Safety and Health; 2006;
  4. King B , McCullough J . NIOSH Health Hazard Evaluation Report 2001-0066-3019, Morton Plant Hospital, Dunedin, Florida . USA: The National Institute for Occupational Safety and Health; 2006;
  5. Gatti JE , Bryant CJ , Noon RB , et al.   The mutagenicity of elec-trocautery smoke . Plastic Reconstr Surg . 1992;89:781–784
  6. Sager PM , Meagher A , Sobczak S , et al.   Chemical composition and potential hazards of electrosurgery smoke . Br J Surg . 1996;83:1792
  7. Hensman C , Baty D , Willis RG , et al.   Chemical composition of smoke produced by high-frequency electrosurgery in a closed gaseous environment . Surg Endosc . 1998;12:1017–1019
  8. Hassan I , Drelichman ER , Wolff BG , et al.   Exposure to electrocautery toxins: understanding a potential occupational hazard . Prof Safety . 2006;4:38–41
  9. Barrett WL , Garber SM . Surgical smoke-a review of literature. Is this just a lot of hot air? . Surg Endosc . 2003;17:979–987
  10. Gatti JE , Murphy JB , Noone RB . Analysis of electrocautery smoke produced during reduction mammoplasty . Surg Forum . 1986;37:579–580
  11. Moot AR , Ledingham KM , Wilson PF , et al.   Composition of volatile organic compounds in diathermy plume as detected by selected ion flow tube mass spectrometry . ANZ J Surg . 2007;77:20–23
  12. Woebkenberg ML . Method no. 4000 Toluene (diffusive sampler) . In:  Schlecht PC ,  O'Connor PF editor. NIOSH Manual of Analytical Methods (NMAM) . 4th edition. Atlanta: NIOSH; 1994;
  13. Pendergrass SM . Method no. 2546 Cresol (all isomers) and Phenol . In:  Schlecht PC ,  O'Connor PF editor. NIOSH Manual of Analytical Methods (NMAM) . 4th edition. Atlanta: NIOSH; 1994;
  14. Okenfuss JR , Kennedy ER . Method no. 2529 Furfural . In:  Schlecht PC ,  O'Connor PF editor. NIOSH Manual of Analytical Methods (NMAM) . 4th edition. Atlanta: NIOSH; 1994;
  15. World Health Organization  . Global Database on Body Mass Index. BMI Classification WHO, 2008 . Available at: http://www.who.int/bmi/index.jsp?introPage=intro_3.html [Date accessed: October 6, 2009]
  16. Cummins K . Occupational Safety and Health Administration Method no. 32 Phenol and cresol. OHSA, 1981 . Available at: http://www.osha.gov/dts/sltc/methods/organic/org032/org032.html
  17. Shulsky M . Occupational Safety and Health Administration Method no. 9 Styrene. OHSA, 1980 . Available at: http://www.osha.gov/dts/sltc/methods/organic/org009/org009.html
  18. Hendricks W . Occupational Safety and Health Administration Method no. 72 Furfural. OHSA, 1988 . Available at: http://www.osha.gov/dts/sltc/methods/organic/org072/org072.html [Date accessed: October 6, 2009]
  19. Elskamp CJ . Occupational Safety and Health Administration Method no. 111 Toluene. OHSA, 1998 . Available at: http://www.osha.gov/dts/sltc/methods/organic/org111/org111.html [Date accessed: October 6, 2009]
  20. Hendricks W . Occupational Safety and Health Administration Method no. 1002 Xylenes (o-, m-, p-isomers), ethylbenzene. OHSA, 1999 . Available at: http://www.osha.gov/dts/sltc/methods/mdt/mdt1002/1002.html [Date accessed: October 6, 2009]
  21. Krones CJ , Conze J , Hoelzl F , et al.   Chemical composition of surgical produced by electrocautery, harmonic scalpel and argon beaming-a short study . Eur Surg . 2007;38:118–121
  22. Agency for Toxic Substances and Disease Registry  . Toxi-cological Profile for Toluene . Atlanta: U.S. Department of Health and Human Services; 2000;
  23. Agency for Toxic Substances and Disease Registry  . Minimal Risk Levels for Hazardous Substances. U.S. Department of Health and Human Services, 2008 . Available from: http://www.atsdr.cdc.gov/mrls/ [Date accessed: October 26, 2008]

PII: S0929-6646(10)60085-X

doi:10.1016/S0929-6646(10)60085-X

Journal of the Formosan Medical Association
Volume 109, Issue 7 , Pages 511-516, July 2010

Article Tools