Operating room with surgical team and Change the Air for safer OR title
Operating room with surgical team and Change the Air for safer OR title

Change the Air
for a safer OR

Surgical smoke, gaseous by-product containing hazardous aerosols, may pose potential health risks for nearly 500,000 hospital workers1,2,3,4,5

'Improving OR Safety During Laparoscopic and Open Surgery and the Role of Smoke Evacuation

Ethicon’s new report looks at how to enhance operating room safety, the impact of COVID-19 on our current environment, the smoke evacuation solutions available in the market and the latest guidance for nurses, surgeons and hospital administrators on reducing the impact of surgical smoke.

Operating room with surgeons completing procedure with visible smoke. COVID-19 and respiratory icons overlaid

Potential dangers of surgical smoke

Hands of surgeon using instruments in surgical procedure producing plume. Smoky overlay and instrument icon.

What is surgical smoke?

Surgical smoke is formed when energy-generating devices raise the intracellular temperature of tissue causing tissue vaporization. Smoke can be described as surgical plume, aerosol and vapor.3,5

Healthcare professional wearing surgical mask and cap. Smoky overlay with medical cross icon.

How can we create a safer OR?

Smoke evacuation is the ability to capture the smoke generated at the surgical site and route it to an area away from the surgical team where it can be filtered. 6

“Plume/smoke evacuation systems should always be used during the procedure with heat producing instruments or devices.”

Healthcare professional wearing mask coughing into elbow. Smoky overlay and medical cross icon.

Why could surgical smoke be hazardous for health?

Approximately 150 chemical constituents have been found in surgical smoke, including carbon monoxide, hydrogen cyanide, acrylonitrile, formaldehyde and benzene.8,9 As well as viable bacteria and infectious viruses such as HIV, hepatitis B and HPV.8,9

The effects of surgical smoke

Two healthcare professionals smiling, wearing blue scrubs and stethoscopes. . Smoky overlay and lungs icon.

Potential Short- and Long-Term Health Risks

CDC*: “Exposure to surgical smoke can cause both acute and chronic health effects ranging from eye, nose and throat irritation to emphysema, asthma or chronic bronchitis.10≠

Operating theater nurses may have an increased prevalence of respiratory illnesses (sometimes twofold) compared to the general population.11*

Surgeon in operating room in blue scrubs, mask and cap. Smoky overlay and eye icon.

Surgical Field Visibility

Surgical smoke may decrease visibility of the surgical field 12

Two healthcare professionals in shirt and tie, talking. Smoky overlay and hopsital icon.

Employee absence due to respiratory illness

Surgical smoke plumes may cause both acute (e.g., sore eyes, dermatitis) or chronic (e.g., asthma) health effects.4

Leading the way in creating a safer OR environment for Nurses

Deep diving into the topics of OR Energy Surgical Fires and Surgical Smoke, through a mix of videos, photos and daily OR examples.
Offered courses:

  • Basics of Electrosurgery
  • Preventing Surgical Fires
  • Understanding Surgical Smoke Plume
Hospital office environment with virtual conference. Smoky overlay and communication speech bubble icon.

We are committed to improving safety in the operating room

Smoke might be hazardous for the health of operating room personnel. Blended current electrosurgery can contain viable bacteria. Viral DNA has been discovered in surgical smoke and may lead to disease transmission.13 Every OR deserves to be smoke-free OR.

Patient in hospital bed. Nurse in blue scrubs standing. Smoky overlay and tick icon.

MEGADYNE Smoke Evacuator

Minimize exposure to surgical smoke in the operating room. The MEGADYNE Smoke Evacuator delivers effective and quiet performance for open and laparoscopic procedures.14-16¥

MEGADYNE™ Smoke Evacuator System product image

Products designed to advance OR safety

The MEGADYNE portfolio offers a full range of electrosurgical products, including smoke evacuation systems, surgical pencils and blades, electrosurgical devices and capital equipment.

Healthcare professional wearing mask coughing by open window. Smoky overlay and smoke icon.


*Ball, K. (nd). Surgical smoke evacuation: Are you compliant? Megadyne

¥Efficiently captures and filters 99.999% of particulates and microorganisms of 0.1 to 0.2 microns and performs quiet at 50 +/- 10 dBa per IEC 60601-1 at 1 m, with [59.2 dBA in open mode] [and/or] [51.9 dBA in lap mode] at 1m

≠Centers for Disease Control and Prevention

πAs recommended by EORNA

1. Memon AG, Naeem Z, Zaman A, Zahid F, Occupational health related concerns among surgeons. Int J Health Sci. 2016;10 (2);279-291.

2. Eickmann U, Falcy M, Fokuhl I, Rüegger M, Bloch M et al, Surgical smoke: Risks and preventive measures. International Section of the ISSA on prevention of occupational risks in health services Hamburg, Germany. 2011;5-40.

3. Barrett WL, Garber SM, Surgical smoke: a review of the literature, Surg Endosc. 2003:17:979-987

4. NIOSH Study Finds Healthcare Workers’ Exposure to Surgical Smoke Still Common. Available at https://www.cdc.gov/niosh/updates/upd-11-03-15.html [accessed 19 Feb 2021]

5. Spruce L, Back to Basics, Protection From Surgical Smoke; AORN J. 2018;108 (1): 24-32

6. Schultz, L, An Analysis of Surgical Smoke Plume Components, Capture, and Evacuation, AORN Journal. 2014;99;2;289-298

7. Prevention and Protection of Surgical Plume 2018. Available at https://eorna.eu/wp-content/uploads/2019/09/Prevention-and-Protection-of-Surgical-Plume-PNC-EORNA.pdf
[accessed 19 Feb 2021]

8. Pierce JS, Lacey SE, Lippert JF, Lopez R, Franke JE, Laser-generated air contaminants from medical laser applications: a state-of-the-science review of exposure characterization, health effects, and control. 2011;8;447;446 (147836-200728)

9. Barrett WL, Garber SM, Surgical smoke: a review of the literature, Surg Endosc. 2003:17:979-987 (147836-200728)

10. NIOSH Study Finds Healthcare Workers’ Exposure to Surgical Smoke Still Common. Nov 3, 2015 available at https://www.cdc.gov/niosh/updates/upd-11-03-15.html [accessed 19.02.2020] (132927-200819)

11. Christie D, Jefferson P, Ball DR, Diathermy smoke and human health. Anaesthesia;2005;60(6): 632

12. Wu JS, Luttmann DR, Meininger TA, Soper NJ, Production and systemic absorption of toxic byproducts of tissue combustion during laparoscopic surgery, Surg Endosc. 1997;11;1075-1079 (166839-210209)

13. Okoshi K, Kobayashi K, Kinoshita K, Tomizawa Y, Hasegawa S, Sakai Y. Health risks associated with exposure to surgical smoke for surgeons and operation room personnel. Surg Today. 2015;45(8):957-965

14. As per Instructions For Use (131252-200127)

15. Ethicon, ENG-RPT-704 Filter Physical characteristics comparison with predicate device filter, Oct 2019, Data on File (131252-200127)

16. Ethicon, ENG-RPT-753, MESE1 competitive sound test report, Feb 2020, Data on File (131252-200127)