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Aerosols and Splatter in Dentistry
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Drills, Orthopedic, Reamers, Saws |
4/1/2004 |
The airborne spread of measles, tuberculosis and SARS is well-documented in the medical literature. The dental literature shows that many dental procedures produce aerosols and droplets that are contaminated with bacteria and blood. These aerosols represent a potential route for disease transmission. The literature also documents that airborne contamination can be minimized easily and inexpensively by layering several infection control steps into the routine precautions used during all dental
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The Journal of the American Dental Association, Vol 135, No 4
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Stephen K. Harrel, DDS; John Molinari, PhD
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Cancer Risk of Incremental Exposure to Polycyclic Aromatic Hydrocarbons in Electrocautery Smoke for Mastectomy Personnel
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General, Plastic
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1/1/2014
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The carcinogenic effects of PAHs in ES on the occupational health of surgical staff should not be neglected. The use of an effective ES evacuator or smoke removal apparatus is strongly suggested to diminish the electrosurgical smoke hazards to surgical staff.
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Hsin-Shun Tseng, Shi-Ping Liu, Shi-Nian Uang, Li-Ru Yang, Shien-Chih Lee, Yao-Jen Liu and Dar-Ren Chen
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Chemical Composition of Smoke Produced by High-frequency Electrosurgery
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Aesthetics, Cardiothoracic, Dermatology, Drills, ENT, General, Laparoscopic, Laser, Orthopedic, Plastic, Plume, Saws, Smoke
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7/1/2007
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This study demonstrated the presence of irritant, carcinogenic and neurotoxic compounds in electrosurgical smoke such as toluene, ethylbenzene and xylene. This may have considerable implications for the health and safety of all involved in surgical practice, as exposure to these compounds pose potential risks to health.
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Irish Journal of Medical Science
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O.S. Al Sahaf; I.Vega-Carrascal; F.O. Cunningham; J.P. MCGrath; F.J. Bloomfield
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Dissemination of Melanoma Cells within Electrocautery Plume
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Dermatology, General, Laparoscopic
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7/1/1999
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Results of this study confirm that application of electrocautery to a pellet of melanoma cells releases these cells into the plume. These cells are viable and may be grown in culture. This release of malignant cells may explain the appearance of port metastases at sites that are remote from the surgical dissection or that were never in direct contact with the tumor.
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Excerpta Medica, Inc., July 1999, Vol 178
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John N. Fletcher, MD; Daphne Mew, PhD, MD, FRCS; Jean-Gaston DesCoˆ teaux, MA, MD, FRCS
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Effects of Plume Produced by the Nd: YAG Laser and Electrocautery on the Respiratory System
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Dermatology, ENT, General, Laser
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1/1/1993
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Lasers have assumed an increasingly important role in otolaryngology head and neck surgery in the past 10 years, with numerous studies in the literature supporting the use of this modality of treatment for various head and neck diseases.
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Wiley-Liss, Inc., Vol 13
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Barry L. Wenig, MD; Kerstin M. Stenson, MD; Diane Tracey, BS
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Electrosurgery Revisted
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Laser, OB/GYN
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2/3/2009
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This article discusses the hazards of surgical smoke plume, including the presence of HPV, HIV and other viruses as well as DNA. They also discuss the use of smoke evacuators.
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Journal of Gynecologic Surgery
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Baggish, Michael
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Evaluation of the Risk of Infection Through Exposure to Aerosols and Splatters in Dentistry
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Dentistry
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5/1/2008
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Many dental procedures produce extensive aerosols and spatters that are routinely contaminated with microorganisms. This study revealed contamination of both air and surfaces by blood particulate. Furthermore, with the exception of one sample, the sedimenting particulate when analyzed was positive for the presence of Hb (Hemoglobin).
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Association for Professionals in Infection Control and Epidemiology
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Maria Luisa Cristina, PhD; Anna Maria Spagnolo, BScD; Marina Sartini, PhD; Maurizio Dallera, BScD; Gianluca Ottria, BScD; Roberto Lombardi, PhD; Fernanda Perdelli, PhD
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Harmful Gasses Produced During Transurethral Resection Of The Prostate And Vaporization
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Electrosurgery, Urology
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1/1/2010
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A total of 12 smoke samples were collected from a continuous irrigation suction drainage system to a Tenax adsorber at a 0.05L/min flow rate during TURP and vaporization. The gasses were quantitatively and qualitatively analyzed by gas chromatography-mass spectrometry (GC-MS) equipped with a purge and trap sample injector.
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The Japanese Urological Association
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Chung YJ; Lee SK; Han SH; Zhao C; Kim MK; Park SC; Park JK
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HPV Positive Tonsillar Cancer in Two Laser Surgeons: Case Reports
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Dermatology, Plastic
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1/1/2013
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A 53 year-old male gynecologist presented with human papillomavirus (HPV) 16 positive tonsillar squamous cell carcinoma. He had no identifiable risk factors with the exception of long term occupational exposure to laser plumes, having performed laser ablations and loop electrosurgical excision procedures (LEEP) on greater than 3000 dysplastic cervical and vulvar lesions over 20 years of practice. The second patient is a 62 year old male gynecologist with a 30 year history of laser ablation and LEEP who subsequently developed HPV 16 positive base of tongue cancer. He also had very few other risk factors for oropharyngeal cancer or HPV infection. HPV is a probable causative agent for oropharyngeal squamous cell carcinoma and has been reported as being transmittable through laser plume.
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Journal of Otolaryngology, Head and Neck Surgery, 42:54
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Margo Rioux, Andrea Garland, Duncan Webster and Edward Reardon
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Maximizing Surgeon Safety During Excimer Laser Photorefractive Procedures
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Laser
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12/1/2002
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This year, it has been estimated that more than 1 million excimer laser procedures will be performed in the United States alone. A number of viral pathogens have been identified in tears and the ocular surface. This raises the possibility that viral particles or subcomponents may become part of the airborne contaminants of the laser that are ejected into the air at supersonic speed during excimer laser ablation. A number of laboratory studies have been designed and executed to test this hypothesis.
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American Journal of Ophthalmology, Vol 130, No 6
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Jay S. Pepose, MD, PhD
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Mutagenicity of Smoke Condensates Induced by CO2 - Laser Irradiation and Electrocauterization
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General
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1/1/1981
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Smoke condensates generated from mucous membrane of the canine tongue irradiated with a CO2 laser showed mutagenicity on Salmonella typhimurium TA98 under metabolic activation with S9 mix. Strain TA100 was not so sensitive to the condensates with or without S9 mix. The revertant number per mg of the smoke condensates from laser irradiation was one-half that of the smoke condensates from electrocauterization (1623 and 3371) in TA98. The mutagenic potency observed was comparable to that of cigarette smoke. The amount of these smoke condensates from 1g of tissue was equivalent to those from 3-6 cigarettes as to total mutagenicity.
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Mutation Research
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Toshifumi Tomita; Shigenobu Mihashi; Kazuto Nagata; Setsuo Ueda; Masakazu Fujiki; Minoru Hirano; Tomio Hirohata
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Presence of Human Immunodeficiency Virus DNA in Laser Smoke |
Laser
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1/1/1991
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Laser vaporous by-products (plume) have been shown to contain fine particulate matter which creates anatomically identifiable lesions when chronically inspired…
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Lasers in Surgery & Medicine, Vol 11
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Michael S. Baggish, MD; Bernard J. Poiesz, MD; Dale Joret, MD; Patrick Williamson, MD; Ashraf Refai, MD
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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
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Aesthetics, Cardiothoracic, Dentistry, Dermatology, Drills, ENT, General, Laparoscopic, Laser, Plastic, Plume, Reamers, Saws, Smoke
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1/1/2012
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This study looked at the contents of surgical plume in the United Kingdom from plastic surgery centers. Their results revealed the equivalent mutagenicity and other hazards as smoking 27-30 cigarettes per day for OR staff. The contents of the plume were very similar to those of tobacco smoke and have the same disease causing capability.
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Elsevier
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D.S.Hill, J.K. O'Neill, R.J. Powell, D.W. Oliver
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Surgical Smoke and Infection Control
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Laparoscopic, Laser
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1/1/2006
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Gaseous byproducts produced during electrocautery, laser surgery or the use of ultrasonic scalpels are usually referred to as ‘surgical smoke’. This smoke, produced with or without a heating process, contains bio-aerosols with viable and non-viable cellular material that subsequently poses a risk of infection (human immunodeficiency virus, hepatitis B virus, human papillomavirus) and causes irritation to the lungs leading to acute and chronic inflammatory changes...
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Journal of Hospital Infection
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E. Alp, D.Bijl; R.P. Bleichrodt; B. Hansson; A. Voss
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Surgical Smoke and the Dermatologist
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Dermatology, Plastic
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1/1/2010
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The use of electrosurgery and lasers by dermatologists and dermatologic surgeons has increased in recent years with the growth of technology and procedures performed. These devices produce surgical smoke that has been demonstrated to harbor live viruses and bacteria in addition to hazardous chemicals.
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American Academy of Dermatology, Inc., 2010, doi:10.1016/j.jaad, 11.017
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Jesse Lewin, Jeremy Brauer, Ariel Ostad
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Surgical Smoke: A Review of the Literature
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General, Laparoscopic
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1/1/2004
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Electrocautery, laser tissue ablation and ultrasonic (harmonic) scalpel tissue dissection all create a gaseous by-product, commonly referred to as ‘smoke’, that can be seen and smelt easily. Concern about this smoke has led to numerous investigations in an effort to determine what, if any, risks this byproduct poses to surgeons, operating room (OR) personnel and/or patients. Some of the findings from these investigations have led to significant concerns regarding the safety of surgical smoke.
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Business Briefing: Global Surgery
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William L. Barrett, MD; Shawn M. Garber, MD
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Surgical Smoke and Ultrafine Particles
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General, Laser
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1/1/2008
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This article takes measures to quantify the amount of particulate that resides within surgical smoke plume during a series of different procedures. As part of their examination, the authors discuss the respiratory hazards associated with the inhalation of particles less than 2.5 microns as these particles are able to reach the deepest regions of the lungs, the alveolar.
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Journal of Occupational Medicine and Toxicology
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Irene Brüske-Hohlfeld; Gerhard Preissler; Karl-Walter Jauch; Mike Pitz; Dennis Nowak; Annette Peters; H-Erich Wichmann
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Surgical Smoke: Plume What Do We Know
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General, Orthopedic, Plastic
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1/1/2009
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This paper provides information of what we know about surgical smoke, the associated health risks and current global recommendations and regulations.
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Covidien
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Donna S. Watson, RN, MSN, CNOR, ARNP-BC
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The Mutagenicity of Electrocautery Smoke
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Plastic
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5/1/1992
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Careful analysis of electrocautery smoke produced during breast surgery has found organic compounds that are unidentifiable with current analytical techniques. The purpose of this study was to determine the potential mutagenicity of the smoke produced by the electrocautery knife during reduction mammoplasty procedures...
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Plastic & Reconstructive Surgery, Vol 89, No 5
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John E. Gatti, MD; Charles J. Bryant, CIH; R. Barrett No one, MD; J. Brien Murphy, MD
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The Visualisation of Surgical Smoke Produced by Energy Delivery Devices: Significance and Effectiveness of Evacuation Systems
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General
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1/1/2007
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Devices delivering energy to biological tissues (eg lasers, RF and ultrasound) can induce surgical smoke consisting of particles, vapor, gasses and aerosols. Besides interfering with the view of the surgeon, the smoke is a risk for the health of both the users and patients. In literature, it has been shown that surgical smoke can contain carcinogenic and harmful biological agents. However, the impact on health of the users and patients is widely debated. The use of smoke evacuation systems in the OR is usually governed by economical reason instead of safety issues. A special image enhancement technique is used to study the behavior of smoke and aerosols and the effectiveness of smoke evacuation systems. A back scatter illumination.
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Proc. of SPIE, Vol. 6440, 64400R
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Tjeerd de Boorder, Rudolf Verdaasdonk, John Klaessens
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Don't Be a Victim of Surgical Smoke
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General, Laparoscopic
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3/1/1996
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If you saw a low-lying cloud that was labeled clearly with its contents, and the label contained the words benzene, carbon monoxide, formaldehyde, hydrogen cyanide, methane, phenol, styrene, and toluene, would you go out of your way to walk through that cloud and inhale those toxic chemicals? Of course not. But you expose yourself to these same toxic chemicals each time you participate in a surgical procedure in which smoke from tissue . . .
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AORN Journal, Vol. 63, No. 3
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Beverly P. Giordano, RN, MS
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Viral Disease Transmitted by Laser-Generated Plume (Aerosol)
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Dermatology, Plastic, Veterinary
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10/1/2002
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Laser plume has been shown, for the first time to our knowledge, to actually transmit disease. Strict cars must be maintained by the laser practitioner to minimize potential health risks, especially when treating viral-induced lesions or patients with viral disease.
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Archives of Dermatology, Vol 138
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Jerome M. Garden, MD; M.Kerry O'Banion, MD; PhD, Abnoeal D. Bakus, PhD; Carl Olson, DVM, PhD
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Chemical Composition of Surgical Smoke Formed in the Abdominal Cavity During Laparoscopic Cholecystectomy- Assessment of the Risk to the Patient
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General, Laparoscopic
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2/1/2014
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This article discusses the finding of various xenobiotics in patient urine following laparoscopic cholecystectomy. These chemicals, including benzene, xylene and toluene, were absorbed by the patient from surgical smoke in their abdomen during laparoscopy and found by urinalysis post operatively. They also discuss various risk factors to the patient from the absorption of these chemicals, including the possibility of fetal harm.
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International Journal of Occupational Medicine and Environmental Health, 27(2):314 – 325
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Dobrogowski, Wesolowski, Kucharske et al
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Surgical Smoke Without Fire: The Risks to the Plastic Surgeon
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Plastic
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11/1/2004
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Plastic surgeons encounter surgical smoke routinely as a by-product either of electrocautery, laser ablation, or ultrasonic (harmonic) scalpel tissue dissection. Strictly speaking, “smoke” is composed of the products of combustion, while “plume” is a mix of combusted and noncombusted particles, the mix and size of which can vary with the device used. The hazards of smoke plume inhalation are real...
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Journal of the American Society of Plastic Surgeons Plastic & Reconstructive Surgery, Vol 114
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R.O.S. Karoo, M.B., M.R.C.S.; I. S. Whitaker, M.A.; Cantab., M.B. B. Chir. G. Offer, M.B. B.Chir., F.R.C.S.;
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Call to Tackle Toxic Surgery Smoke Risk for Doctors, Nurses, Patients
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Aesthetics, Cardiothoracic, Dentistry, Dermatology, Drills, ENT, General, Laparoscopic, Laser, OB/GYN, Orthopedic, Plastic, Plume, Reamers, Saws, Veterinary
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5/29/2016
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Surgeons, nurses and patients are being exposed to toxic surgical smoke from burnt body parts, and health staff want new safety measures to combat the risks in New Zealand hospitals.
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Stuff.co.nz
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John Weekes
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The Examination of Problems Experienced by Nurses and Doctors Associated with Exposure to Surgical Smoke and the Necessary Precautions
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Aesthetics, Cardiothoracic, Dermatology, ENT, General, OB/GYN, Orthopedic, Plastic, Veterinary
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7/1/2016
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This article researches the problems experienced by the nurses and doctors as a result of exposure to surgical smoke included: headache, watering of the eyes, cough, sore throat, bad odors absorbed in the hair, and nausea; then drowsiness, dizziness, sneezing and rhinitis.
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Journal of Clinical Nursing
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Health Risk Assessment of VOCs from Surgical Smoke
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Aesthetics, Cardiothoracic, Dermatology, Drills, Electrosurgery, ENT, General, Laparoscopic, Laser, Orthopedic, Plastic, Plume, Reamers, Saws, Smoke, Urology, Veterinary
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7/1/2017
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The authors conduct a health risk analysis based on exposure to surgical smoke and length of exposure. They found an increased risk of cancer based on the quantity of benzene and formaldehyde found in surgical smoke. They recommend the use of a high flow vacuum device to remove surgical smoke at the source as a means of protection.
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Creative Commons CC
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Shaohua She, Gang Lu, Wah Yang, Mianwei Hong, and Lingfei Zhu
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Health Risk Assessment of VOCs from Surgical Smoke
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a, Aesthetics, Cardiothoracic, Dermatology, General, Laparoscopic, Laser, Plastic, Reamers, Saws, Veterinary
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7/17/2017
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The authors conduct a health risk analysis based on exposure to surgical smoke and length of exposure. They found an increased risk of cancer based on the quantity of benzene and formaldehyde found in surgical smoke. They recommend the use of a high flow vacuum device to remove surgical smoke at the source as a means of protection.
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Creative Commons CC
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Shaohua She, Gang Lu, Wah Yang, Mianwei Hong, and Lingfei Zhu
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Surgical Smoke Nearly Killed Me
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Electrosurgery, Orthopedic
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2/1/2018
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The personal story of Dr. Anthony Headley of the Headley Orthopaedic Institute in Phoenix AZ.
Dr. Headley developed idiopathic pulmonary fibrosis and had a double lung transplant. He states that the cause was exposure to surgical smoke.
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Outpatient Surgery Magazine February 2018 XIX, No. 2
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Anthony Hedley, MD, FACS
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The Examination of Problems Experienced by Nurses and Doctors Associated with Exposure to Surgical Smoke and the Necessary Precautions
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Aesthetics, Cardiothoracic, Dermatology, ENT, General, Laser, OB/GYN, Orthopedic, Veterinary
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1/1/2018
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This article researches the problems experienced by the nurses and doctors as a result of exposure to surgical smoke included: headache, watering of the eyes, cough, sore throat, bad odors absorbed in the hair, and nausea; then drowsiness, dizziness, sneezing and rhinitis.
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Journal of Clinical Nursing
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Arzu Ilce, Ganime Esra, Yuzden, Meryem Yavuz van Giersbergen
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