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Surgical smoke and the orthopedic surgeon: a non-systematic review of the hazards and strategies for mitigating risk

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Surgical smoke generated through the use of electrical surgical devices poses a risk to the surgeon, medical personnel in the operating room, and the patient by exposing them to environmentally hazardous particulate matter. Previous investigation has shown that surgical smoke leads to an increased risk of pulmonary conditions, circulatory disorders, and irritation of the eyes, nose, and throat. Transmission of infectious disease can occur through inhalation of viral particles, and the presence of carcinogens are also of major concern. The deleterious effects of surgical smoke are well documented in several subspecialties, namely dermatology and general surgery, but there has been little discussion on the topic amongst orthopedic surgeons.

Methods

A non-systematic review of the literature was completed with the aim of identifying the major categories of adverse health effects associated with surgical smoke inhalation and offering recommendations to reduce these hazards in the orthopedic surgical community.

Results

Three primary categories of risk associated with surgical smoke inhalation were identified: inflammation, viral/bacterial transmission, and carcinogenicity. In addition, strategies for mitigating risk and best practice recommendations were explored.

Conclusion

Surgical smoke is an under-recognized occupational hazard within the orthopedic surgery literature. There are several strategies which can be employed to reduce risk. Further investigation is needed to understand the long-term impact of these risks, as well as what can be done to improve the practicality and compliance with protective measures.

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Data availability

Data sharing is not applicable to this article as no new data were created or analyzed in this study.

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Funding

There were no sources of funding for the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, 2160 S 1St Ave, Suite 1700, Maywood, IL, 60153, USA

    Ryan LeDuc, Carlo Eikani, Adam Schiff & Nicholas Brown

  2. Department of Orthopaedic Surgery, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA

    Brooke Dickens

Authors
  1. Ryan LeDuc
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  2. Carlo Eikani
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  3. Brooke Dickens
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  4. Adam Schiff
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  5. Nicholas Brown
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Correspondence to Ryan LeDuc.

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Conflict of interest

Dr. Brown is a paid consultant for Depuy/Synthes and Corin USA and board or committee member of American Academy of Orthopaedic Surgeons. Dr. Schiff is a paid consultant for DJ Orthopaedics, Regeneration Technologies, Inc., Restor3D, and Stryker. All other authors have no competing interests to declare. There were no sources of funding for this review.

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This manuscript does not involve Protected Health Information (PHI); therefore, Institution Review Board (IRB) approval was not indicated.

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LeDuc, R., Eikani, C., Dickens, B. et al. Surgical smoke and the orthopedic surgeon: a non-systematic review of the hazards and strategies for mitigating risk. Arch Orthop Trauma Surg 143, 6975–6981 (2023). https://doi.org/10.1007/s00402-023-04967-y

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  • DOI: https://doi.org/10.1007/s00402-023-04967-y

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