Kirurginen savu toimenpiteissä : henkilöstön riskit ja suojaus
Lankinen, Petteri; Parkkila, Anna-Kaisa; Roine, Risto P.; Turpeinen, Miia (2019-10-25)
Lankinen, Petteri, Parkkila, Anna-Kaisa, Roine, Risto P., Turpeinen, Miia (2019) Kirurginen savu toimenpiteissä : henkilöstön riskit ja suojaus. Lääkärilehti 74(43): 2439-2442. https://www.laakarilehti.fi/tieteessa/katsausartikkeli/kirurginen-savu-toimenpiteissa-ndash-henkiloston-riskit-ja-suojaus-3237/
© 2019 Lääkärilehti.
https://rightsstatements.org/vocab/InC/1.0/
https://urn.fi/URN:NBN:fi-fe2020092275518
Tiivistelmä
Tiivistelmä
Monia sähkökirurgisia instrumentteja käytettäessä syntyy kirurgista savua.
Henkilöstö voi altistua kumulatiivisesti savun haitallisille komponenteille.
Tavallinen kirurginen hengityssuojain antaa yli 90-prosenttisen suojan. Lisäksi tulisi käyttää asianmukaisella suodattimella varustettua paikallista savunpoistolaitteistoa.
Savulle altistumisen ei ole osoitettu lisäävän sairastavuutta tai syöpäriskiä.
Abstract
In this article, we review the evidence on potential hazards of surgical smoke. The purpose is to review the literature and summarize current recommendations for protection against hazards of surgical plume. Operating room personnel are exposed to various hazardous substances and radiation in their work, and the cumulative exposure may lead to increased risk of adverse health events. Due to the possible occupational health and safety risk there is a growing interest in identifying the composition of surgical smoke and the necessary protective measures.
Surgical smoke is formed when electrosurgical instruments are used in cutting and coagulating. The composition and the amount of surgical smoke produced vary. The factors influencing the formation of surgical plume include the type of surgery, the target tissue and its pathology, the type of instrument used and the amount of cutting and coagulating performed. Surgical smoke is composed of gases and vapours, as well as particles of biological origin, including potentially viable pathogens. In addition, surgical smoke contains ultrafine particles which may deposit in the respiratory tract.
Although there is currently no evidence that exposure to surgical smoke causes increased morbidity and mortality, attention to potential hazards of surgical smoke is warranted. General room ventilation and the use of room suction units, primarily designed for capture of liquids, are not sufficient alone to control more substantial exposure to hazards of surgical smoke. The most effective way to control exposure to surgical smoke is to remove smoke at the surgical site using local exhaust ventilation (LEV). Personal filtration masks, such as surgical masks and high filtration masks, are efficient and their use alongside LEV systems is recommended.
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