Eliminating the hazards of surgical plume

Steve Veck, an electro surgery consultant, discusses the dangers associated with surgical plume and the need for plume evacuation devices. He argues that the UK is lagging behind other countries in implementing statutory legal requirements. 

Surgical plume is an inevitable result of interventional procedures where electrosurgery (diathermy), laser and ultrasonic devices cut into tissue. It can release an unpleasant odour but, more importantly, can contain toxic, infectious or carcinogenic material – such as hydrogen peroxide gas, human papillomavirus (HPV) or SARS-CoV-2 – that could be hazardous to theatre staff or indeed the patient. As a result, exposure to surgical plume has been linked to eye, nose and throat irritation, nausea, headaches, coughs, nasal congestion, asthma, and asthma-like symptoms. 

Several plume evacuation devices designed to capture and remove the surgical plume from the operating site have emerged in an attempt to overcome its dangers and, while they offer a safe solution for many operating procedures, not all countries mandate their use, and they are not used routinely in the majority of surgical specialties – the one exception being gynaecology. This article explores the incidence of surgical plume and discusses how and why this issue should be efficiently and consistently eradicated from surgical departments everywhere.