OP E R ATING THEATR E S
the HEPA filter before it reaches the main evacuation generator, which prolongs the life of the second filter, allowing it to last up to around 35 hours of continuous use which, in a typical colposcopy clinic, would be enough for around six months. The filters are not single use and are expensive to replace, so this is a more cost-effective solution. “One disadvantage of some plume evacuation devices is the loud and quite unnerving noise that they generate, but this has been totally eliminated from the new kit, which is especially important in colposcopy given that the patient is awake throughout the procedure and is aware of everything going on in the room. At a time when patients are understandably apprehensive of the underlying reason for the procedure in the first place, this helps to create a more calming and less distracting environment,” Steve continued.
The unmistakable need for plume evacuation devices
Despite the fairly widespread knowledge that surgical plume has a detrimental effect on health, there is still a long way to go in incorporating plume evacuation devices into daily clinical practice. While most colposcopy units are suitably equipped, in contrast the majority of general surgical operating theatres do not include it in their safety protection measures.
“Despite what might seem an obvious matter to address under the Health and Safety at Work Act, there is no legislation in the UK to designate plume evacuation devices as legal requirements in the operating room. However, other countries have been far better at adopting them into routine work,” argued Steve.
He pointed out that in Scandinavia, for example, a mandatory policy for surgical plume devices has been introduced across all healthcare disciplines, not just gynaecology.
This has even been extended into the training setting; operations on cadaveric material to learn new surgical techniques now incorporate plume elimination devices. Similarly, in Australia, New South Wales now has a mandatory policy in place, and similar regulations are under consideration in other states.
“In various US states and Canada, measures are also starting to emerge but, until recently, the UK has been slow to acknowledge this hazard. That is until the recent COVID-19 pandemic, which has really brought the dangers of airborne particulate transmission to the fore,” Steve commented.
He pointed out that aerosol generating procedures, that can lead to airborne particles dispersing from a patient’s respiratory tract into the surrounding
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environment (potentially including SARS- CoV-2), are now heavily regulated to protect staff working in close proximity. Higher levels of PPE are compulsory and waiting times have been introduced before other members of staff can enter the operating room to ensure that the air in the room has been sufficiently filtered.
“Healthcare providers have a sharpened awareness of the need to protect their staff to make sure that a functioning workforce is always available with no shortages and, unsurprisingly, there has been a huge surge in interest and demand for surgical plume evacuation devices. “The wide range of potentially hazardous and toxic particles in surgical plume is a universal risk common to all surgical specialties, present for both staff and patient. It is hoped that this newfound appreciation and understanding of airborne transmission,
alongside the critical need to protect healthcare staff, that has been sparked by the COVID-19 pandemic, will continue into the future to make the healthcare environment a safer place. Surgical plume evacuation kits deserve to finally play a role in this,” Steve concluded.
CSJ About the author
Steve Veck has 30 years’ experience in teaching and lecturing on the subjects of electrosurgery and surgical plume. He currently lectures at both the Royal College of Surgeons and Royal College of Physicians, as well as several universities. He is also a faculty member of a medical academy in Switzerland.
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© Erbe Elektromedizin GmbH 2019
2019-07
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