Optical fibres are used to deliver laser light to handheld laser devices in dermatology

safety: more than smoke and mirrors’, will address the topic of surgical smoke and plume, a harmful by-product that is produced when tissue is vaporised during laser surgery. Surgical plume contains carbon, cellular debris, viral particulates, toxic gases such as carbon monoxide and benzene, and a number of carcinogenic and mutagenic substances. Patti Owens, one of the certified medical laser safety officers (MLSOs) leading the seminar, commented: ‘The latest research will be presented, analysing the toxicity of surgical plume, the impact of chronic exposure to second-hand smoke, recommended respiratory protection, new international initiatives and organisations, along with future legislation for management of this health hazard.’ Owens is a member of the

Laservision’s EyeLids allow doctors to access most of the patient’s face while ensuring patient safety

“These symptoms are not only harmful, but could distract a doctor in the middle of a delicate medical procedure”

International Council on Surgical Plume (ICSP), a non-profit organisation committed to eliminating the risks associated with surgical plume by educating medical laser users, conducting safety research and supporting new safety standards. According to the organisation, although there are a number of standards, guidelines, and recommended professional practices currently published addressing surgical plume, they fail to have a meaningful impact due to a current lack of enforcement. The ICSP emphasises that, in order for these standards and guidelines to be enforced, they must first become legal mandates. The council believes that: ‘[A] shift to required compliance prevents staff from having to work in an at-risk environment, and patients’ safety from being jeopardised.’ Surgical plume is a hazard to both

patients and anyone working in an enclosed | @electrooptics

space where a laser is being used to ablate tissue. In instances where healthcare workers have been exposed, a number of symptoms have been experienced, including burning or running eyes, coughing, sore throats, asthma, allergic reactions, nausea and headaches. These are not only harmful, but could distract a doctor in the middle of a delicate procedure. Plume generation is a topic also currently being explored by the Laser Institute of America (LIA). ‘This is something I think that all LSOs in the medical community need to be aware of,’ commented Gus Anibarro, education director at the LIA, which regularly run MLSO training courses. According to Anibarro, The National Institute for Occupational Safety and Health has conducted studies into plume generation, which

has shown that a plume extraction system should be used within two inches of the point of ablation in laser surgery. Anibarro raised the topic of whether

certified N95 filtration masks need to be worn alongside the use of a smoke evacuation system. ‘The answer to that is yes, because if you aren’t capturing all the smoke then these particulates are going to float through the air and you are going to inhale them if you are just using a standard surgical mask,’ stated Anibarro. However, ‘the standard does not require

you to use both, it requires you to do one or the other, but it prefers you to use the smoke evacuation system,’ he continued. As mentioned by the ICSP, guidelines advising the use of both smoke evacuators and filtration masks would have to become compulsory mandates to fully ensure the safety of both patients and doctors in surgical procedures. EO

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