A CROSS-SECTIONAL STUDY OF SURGICAL SMOKE INHALATION, ITS HAZARDS AND PREVENTION AMONG PAEDIATRIC SURGICAL RESIDENTS IN PAKISTAN

Authors

  • Murad Habib Department of Paediatric Surgery, The Children’s Hospital Pakistan Institute of Medical Sciences Islamabad-Pakistan
  • Muhammad Amjad Chaudhary Department of Paediatric Surgery, The Children’s Hospital Pakistan Institute of Medical Sciences Islamabad-Pakistan

DOI:

https://doi.org/10.55519/JAMC-04-12200

Abstract

Background: For thousands of years human beings have been using heat as a source of ligature and to treat the wound either it’s from the trauma or fought in the wars. In 1854 an imminent surgeon Albrecht Theodor Middendorf published a paper on the application of electrocautery in surgical operations. The objective of the study was to analyze the hazards of surgical smoke inhalation in Paediatric Surgery residents and to create awareness of its signs and symptoms, risk factors and utilizing preventive measures. Methods: A Cross-sectional study was conducted involving all the Paediatric Surgery residents enrolled on a supervised training program in Pakistan between 1st July 2022 to 30th June 2023 at all the tertiary care hospitals in Pakistan. Their socio-demographic, academic data, signs and symptoms and risk factors were calculated. Data was analyzed with descriptive and comparative analysis using SPSS. A Pearson contingency coefficient is used to determine the association between categorical variables. Results: Our study included all the Paediatric Surgery residents in Pakistan n=155 over a span of one year starting from July 1st 2022 to June 30th 2023. N=75 (48.4%) were males and n=80 (52.6%) were female residents. Their mean age was 29.5 years±4 (SD). 41% of the residents were from Khyber Teaching Hospital, 32% from Children’s Hospital, 14% from National Institute of Child Health Karachi, 9.8% from Children’s Hospital Islamabad (PIMS) and 5.2% from Lady Reading Hospital Peshawar. N=135 (87.1%) of the residents used electrocautery while performing the surgery (p=0.006). N=121 (78.1%) were aware of its hazards (p=0.341). 90% think they are at an increased risk (p=0.032). Most of them (84.6%) wear a surgical mask while only (64%) wear protective equipment (p=0.321). Think they are at an increased risk of cancers (83.9%) (p=0.002) and should be screened (93.7%) (p=0.343). Conclusion: Paediatric surgery residents are at an increased risk of surgical smoke inhalation, pointing to the emerging need to adopt protective measures by creating awareness, and utilizing health safety checklists and smoke evacuation mechanisms in operation rooms. All residents should seek knowledge on the subject and use personal protective equipment for less harmful effects on their health.

References

Middeldorpf AT. Die Galvanocaustik: ein Beitrag zur operativen Medicin: Max; 1854.

Sachs M, Sudermann H. [History of surgical instruments: 7. The first electrosurgical instruments: galvanic cauterization and electric cutting snare]. Zentralbl Chir 1998;123(8):950–4.

O'Connor JL, Bloom DA. William T. Bovie and electrosurgery. Surgery 1996;119(4):390–6.

Karsai S, Däschlein G. “Smoking guns”: hazards generated by laser and electrocautery smoke. J Dtsch Dermatol Ges 2012;10(9):633–6.

Yeganeh A, Hajializade M, Sabagh AP, Athari B, Jamshidi M, Moghtadaei M. Analysis of electrocautery smoke released from the tissues frequently cut in orthopedic surgeries. World J Orthop 2020;11(3):177–83.

Wu YC, Tang CS, Huang HY, Liu CH, Chen YL, Chen DR, et al. Chemical production in electrocautery smoke by a novel predictive model. Eur Surg Res 2011;46(2):102–7.

Gatti JE, Bryant CJ, Noone RB, Murphy JB. The mutagenicity of electrocautery smoke. Plast Reconstr Surg 1992;89(5):781–4.

Hill DS, O’Neill JK, Powell RJ, Oliver DJW. Surgical smoke–a health hazard in the operating theatre: a study to quantify exposure and a survey of the use of smoke extractor systems in UK plastic surgery units. J Plast Reconstr Aesthet Surg 2012;65(7):911–6.

Fan JKM, Chan FSY, Chu KM. Surgical smoke. Asian J Surg 2009;32(4):253–7.

Schultz LJ. An analysis of surgical smoke plume components, capture, and evacuation. AORN J 2014;99(2):289–98.

Okoshi K, Kobayashi K, Kinoshita K, Tomizawa Y, Hasegawa S, Sakai Y. Health risks associated with exposure to surgical smoke for surgeons and operation room personnel. Surg Today 2015;45(8):957–65.

Lewin JM, Brauer JA, Ostad AJJ. Surgical smoke and the dermatologist. J Am Acad Dermatol 2011;65(3):636–41.

Barrett WL, Garber SM. Surgical smoke: a review of the literature. is this just a lot of hot air? Surg Endosc 2003;17(6):979–87.

Spruce L. Back to Basics: Protection From Surgical Smoke: 1.2 www. aornjournal. org/content/cme. ARON J 2018;108(1):24–32.

Steege AL, Boiano JM, Sweeney MH. Secondhand smoke in the operating room? Precautionary practices lacking for surgical smoke. Am J Ind Med 2016;59(11):1020–31.

Mowbray N, Ansell J, Warren N, Wall P, Torkington J. Is surgical smoke harmful to theater staff? A systematic review. Surg Endosc 2013;27(9):3100–7.

Moot AR, Ledingham KM, Wilson PF, Senthilmohan ST, Lewis DR, Roake J, et al. Composition of volatile organic compounds in diathermy plume as detected by selected ion flow tube mass spectrometry. ANZ J 2007;77(1‐2):20–3.

Addley S, Quinn D. 1408 Surgical smoke–what is it and what are the risks? a review. Occup Environ Med 2018;75(Suppl):A321.

Bigony L. Risks associated with exposure to surgical smoke plume: a review of the literature. AORN J 2007;86(6):1013–24.

Ulmer BC. The hazards of surgical smoke. AORN J 2008;87(4):721–38.

Brüske-Hohlfeld I, Preissler G, Jauch KW, Pitz M, Nowak D, Peters A, et al. Surgical smoke and ultrafine particles. J Occup Med Toxicol 2008;3(1):31.

Additional Files

Published

2023-10-10

Issue

Vol. 35 No. 4 (2023): JOURNAL OF AYUB MEDICAL COLLEGE ABBOTTABAD

Section

ORIGINAL ARTICLE

License

Copyright (c) 2023 Murad Habib, Muhammad Amjad Chaudhary

Creative Commons License

This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License  CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.

USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.

AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.