Surgical Team’s Knowledge of Electrocauterization Smoke Complications in Several Educational Hospitals in Mashhad, Iran, in 2014

Document Type : Original article

Authors

1 PhD Candidate, Department of Anatomical Sciences and Cell Biology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 PhD Candidate, Department of Medical Biotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Instructor, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran

4 MSc, Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

5 MSc , Department of Anatomical Sciences and Cell Biology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

6 PhD Candidate, Department of Nursing, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Introduction: The electrocauterization smoke is a plume that is produced from the interaction of tissue and electrocautery. This smoke consists of hazardous material that causes complications, such as respiratory disorders, nausea, vomiting, eye irritation, headache, and transmitting the viruses of human papillomavirus and hepatitis. The purpose of the present study was to determine the surgical team's knowledge of these complications in Mashhad educational hospitals, Mashhad, Iran, in 2014.
Materials and Methods: This was a descriptive-cross sectional study carried out on 140 members of the surgical team of Mashhad educational hospitals in 2012 by census method. Data were collected by a researcher-designed questionnaire titled “surgical team’s knowledge of electrocauterization smoke complications”. Obtained data were analyzed by SPSS software (version 16), Kruskal-Wallis test, and Mann-Whitney U test. The significant level was considered PResults: Obtained results showed a significant relationship between knowledge and gender (P=0.02) so that the knowledge of the men was higher than that of the women. Also, there was no significant relationship between knowledge with the educational level (P=0.591) and work experience (P=0.286). According to the results, the mean score of the participants’ knowledge was 7.7±4.01 so that 75% of the participants had a low level of knowledge of electrocauterization smoke complications. The lowest levels of knowledge were related to women (55.7%), participants with a bachelor’s degree (47.8%), and individuals with work experience of 0-10 years (42.8%),
Conclusion: Regarding the fact that the knowledge level of the surgical team in Mashhad educational hospitals is low, it is recommended to upgrade the level of knowledge of the healthcare personnel by holding workshops or writing pamphlets. 

Keywords


  1. Ulmer BC. Report of OSHA's draft: information  for health care workers exposed to laser and electrosurgery smoke. Today's Surg Nurse. 1999; 21(2):18-9.
  2. Novak DA, Benson SM. Understanding and controlling the hazards of surgical smoke. Prev Infect Ambul Care. 2011; 1:3-5.
  3.  Hensman C, Baty D, Willis RG, Cuschieri A. Chemical composition of smoke produced by high frequency electrosurgery in a closed gaseous environment. An in vitro study. Surg Endosc. 1998; 12(8):1017-9.
  4. Ulmer BC. The hazards of surgical smoke. AORN J. 2008; 87(4):721-34.
  5. Weld KJ, Dryer S, Ames CD, Cho K, Hogan C, Lee M, et al. Analysis of surgical smoke produced by various energy-based instruments and effect on laparoscopic visibility. J Endourol. 2007; 21(3):347-51. 
  6. Chen CC, Willeke K. Aerosol penetration through surgical masks. Am J Infect Control. l992; 20(4):177-84.     
  7. Kunachak S, Sobhon P. The potential alveolar hazard of carbon dioxide laser-induced smoke. J Med Assoc Thai. 1998; 81(4):278-82.
  8. Weber A, Willeke K, Marchioni R, Myojo T, McKay R, Donnelly J, et al. Aerosol penetration and leakage characteristics of masks used in the health care industry. Am J Infect Control. 1993; 21(4):167-73.
  9. Baggish MS, Elbarky M. The effects of laser smoke on the lungs of rats. Am J Obstet Gynecol. 1987; 156(5):1260-5.
  10. Wenig BL, Stenson KM, Wenig BM, Tracey D. Effects of plume produced by laser and electrocautery on the respiratory system. Lasers Surg Med. 1993; 13(2):242-5.
  11. Garden JM, O'Banion MK, Bakus AD, Olson C. Viral disease transmitted by laser-generated plume (Aerosol). Arch Dermatol. 2002; 138(10):1303-7.
  12. Alp E, Bijl D, Bleichrodt RP, Hansson B, Voss A. Surgical smoke and infection control. J Hosp Infect. 2006; 62(1):1-5.
  13. Ferenczy A, Bergeron C, Richart RM. Human papilloma virus DNA in CO2 laser-generated plume of smoke and its consequences to the surgeon. Obstet Gynecol. 1990; 75(1):114-8.
  14. Sawchuk WS, Weber PJ, Lowy DR, Dzubow LM. Infectious papillomavirus in the vapour of warts treated with carbon dioxide laser or electrocoagulation: detection and protection. J Am Acad Dermatol. 1989; 21(1):41-9.
  15. Hill DS, O'Neill JK, Powell RJ, Oliver DW. 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.
  16. Fencl JL. Guideline implementation: surgical smoke safety. AORN J. 2017; 105(5):488-97.
  17. Andreasson SN, Anundi H, Sahlberg B, Ericsson CG, Walinder R, Enlund G, et al. Peritonectomy with high voltage electrocautery generates higher levels of ultrafine smoke particles. Eur J Surg Oncol. 2009; 35(7):780-4.
  18. Khoshdel H, Amouzeshi A, Amouzeshi Z, Unesi Z. Surgical team' knowledge about electrocautery smoke complications in the educational hospitals in Birjand, 2011. J Surg Trauma. 2014; 1(3):55-8.
  19. Ball K. Compliance with surgical smoke evacuation guidelines: implications for practice. AORN J. 2010; 92(2):42-9.
  20. Ball K. Surgical smoke evacuation guidelines: compliance among perioperative nurses. AORN J. 2010; 92(2):e1-23.
  21. Massarweh NN, Cosgriff N, Slakey DP. Electrosurgery: history, principles, and current and future uses. J Am Coll Surg. 2006; 202(3):520-30. 
  22. Al Sahaf OS, Vega-Carrascal I, Cunningham FO, McGrath JP, Bloomfield FJ. Chemical composition of smoke produced by high-frequency electrosurgery. Ir J Med Sci. 2007; 176(3):229-32.
  23. Ortolano GA, Cervia JS, Canonica FP. Surgical smoke: a concern for infection control practitioners. Manag Infect Control. 2009; 9(8):48-54.
  24. Tan E, Russell K. Surgical plume and its implications: a review of the risk and barriers to a safe work place. ACORN J Perioperat Nurs Aust. 2017; 30(4):33-9.
  25.  Lehman DS, Phillips CK, Hruby GW, Lambert S, Landman J. An assessment of urologists’ training and knowledge of energy based surgical devices. BJU Int. 2008; 102(2):226-30.
  26. Clark SC. Are surgeons aware of the dangers of diathermy? Ann R Coll Surg Engl. 2002; 84(5):369.
  27. Sudhindra TV, Joseph A, Hacking CJ, Haray PN. Are surgeons aware of the dangers of diathermy? Ann R Coll Surg Engl. 2000; 82(1):31-2.
  28. Ünver S, Topçu SY, Findik ÜY. Surgical smoke, me and my circle. Int J Car Sci. 2016; 9(2):697-703.
  29. Marzouk DA. Assessment of operating room in Ain Shams University Hospital: knowledge and experience of operating room personnel about occupational hazards. Egypt J Community Med. 1999; 17:1-3.