Volume 109, Issue 7 , Pages 511-516, July 2010
A Novel Inspection Protocol to Detect Volatile Compounds in Breast Surgery Electrocautery Smoke
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
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References
- Smoke in the operating theater: an unregarded source of danger . Plast Reconstr Surg . 2004;114:458–463
- . NIOSH Health Hazard Evaluation Report 2000-0402-3021, Inova Fairfax Hospital, Falls Church, Virginia . USA: The National Institute for Occupational Safety and Health; 2006;
- . NIOSH Health Hazard Evaluation Report 2001-0030-3020, Carolina Medical Center, Charlotte, North Carolina . USA: The National Institute for Occupational Safety and Health; 2006;
- . NIOSH Health Hazard Evaluation Report 2001-0066-3019, Morton Plant Hospital, Dunedin, Florida . USA: The National Institute for Occupational Safety and Health; 2006;
- The mutagenicity of elec-trocautery smoke . Plastic Reconstr Surg . 1992;89:781–784
- Chemical composition and potential hazards of electrosurgery smoke . Br J Surg . 1996;83:1792
- Chemical composition of smoke produced by high-frequency electrosurgery in a closed gaseous environment . Surg Endosc . 1998;12:1017–1019
- Exposure to electrocautery toxins: understanding a potential occupational hazard . Prof Safety . 2006;4:38–41
- . Surgical smoke-a review of literature. Is this just a lot of hot air? . Surg Endosc . 2003;17:979–987
- . Analysis of electrocautery smoke produced during reduction mammoplasty . Surg Forum . 1986;37:579–580
- Composition of volatile organic compounds in diathermy plume as detected by selected ion flow tube mass spectrometry . ANZ J Surg . 2007;77:20–23
- . Method no. 4000 Toluene (diffusive sampler) . In: Schlecht PC , O'Connor PF editor. NIOSH Manual of Analytical Methods (NMAM) . 4th edition. Atlanta: NIOSH; 1994;
- . 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;
- . Method no. 2529 Furfural . In: Schlecht PC , O'Connor PF editor. NIOSH Manual of Analytical Methods (NMAM) . 4th edition. Atlanta: NIOSH; 1994;
- . 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]
- . 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
- . Occupational Safety and Health Administration Method no. 9 Styrene. OHSA, 1980 . Available at: http://www.osha.gov/dts/sltc/methods/organic/org009/org009.html
- . 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]
- . 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]
- . 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]
- Chemical composition of surgical produced by electrocautery, harmonic scalpel and argon beaming-a short study . Eur Surg . 2007;38:118–121
- . Toxi-cological Profile for Toluene . Atlanta: U.S. Department of Health and Human Services; 2000;
- . 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
© 2010 Formosan Medical Association & Elsevier. Published by Elsevier Inc. All rights reserved.
Volume 109, Issue 7 , Pages 511-516, July 2010
