Assessment of Airborne Surgical Plume Particles and Exposures to Operating Room Personnel during Selected Surgical Procedures

Friday, April 25, 2014
Denis F. Branson, MD, St Joseph's Hospital Health Center, Syracuse, NY and Bradley King, Centers for Disease Control and Prevention, Denver, CO
Goals/Purpose: Health hazards of surgical aerosols remain a safety concern for operating room staff & patients.  This study represents phase I of characterization of surgical plume during surgery using electrocautery and PlasmaJet neutral argon cautery.

Methods/Technique: Under an IRB approved protocol, surgery was performed at an outpatient hospital surgery center.  The operating room had HEPA filtered laminar air flow with a measure average 23 room air exchanges per hour.  Particle concentration was measured using condensation particle counters (CPC).  Particle size distribution was measured using wide-spectrum particle spectrometer (WPS).  Measurements were taken in the personal breathing zone at the anesthesia  machine (location A), the nurse’s work station (location B), and at the room exhaust grate. Local exhaust ventilation (LEV) was provided by a Buffalo filter unit near the source of aerosol production.

Results/Complications: Particle concentrations were higher closer to the source of plume production.  LEV resulted in both a fivefold reduction in particle concentration.  Use of the bovie and plasma jet to cut or cauterize during the surgeries produced peaks of particles with geometric mean diameter around 0.09–0.11 micrometers; use of the plasma jet for its antibacterial purposes produced peaks with smaller GMD around 0.03 micrometers. There were no complications.

Conclusion:  This study adds to the understanding of surgical plume particles produced during surgery and the benefits of local controls such as LEV and general exhaust.

Figure 1: Brachioplasty particle concentration with & without LEV

Figure 2: Brachioplasty particle size distribution with & without LEV

Figure 3: Thighplasty particle concentration with & without LEV

Figure 4: Thighplasty particle size distribution with LEV

Figure 5: Thighplasty particle size distribution without LEV