Review: Surgical Smoke: Risks Assessment and Mitigation Strategies

Publication date: Available online 11 June 2018
Source:Journal of the American Academy of Dermatology
Author(s): Corey Georgesen, Shari R. Lipner
BackgroundAlthough many dermatologic surgeons are aware of the risks of surgical smoke, many do not employ hazard reduction strategies.ObjectiveTo identify the infectious, inhalational, chemical, and mutagenic risks of surgical smoke in dermatologic procedures and suggest evidence based hazard reduction strategies.MethodsA review of articles indexed for MEDLINE on PubMed using keywords "surgical smoke", "dermatology", "surgical mask", "respirator", "smoke evacuator", and "guidelines" was performed in 13 combinations using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocols. This review includes data from 45 manuscripts from the dermatology, surgery, infectious disease, obstetrics, and cancer biology literature.ResultsThere are risks associated with surgical smoke, and although some dermatologists are aware of these risks, many are not using hazard reduction strategies such as smoke evacuators and surgical masks.LimitationsMost of the data regarding surgical smoke hazards and methods for smoke safety is derived from in vitro and non-human in vivo studies, in addition to resources outside of the dermatology literature.ConclusionStandardized guidelines for surgical smoke safety should be implemented in the dermatology community and residency curriculum.

Teaser

Dermatologists are repeatedly exposed to surgical smoke from lasers and electrosurgery.; There are relevant infectious, direct physical, chemical, and mutagenic risks of surgical smoke.; These risks can be minimized by use of respirator masks and smoke evacuation systems.