Cerrahi Duman, Etkileri ve Önlemler

Yıl 2020, Cilt: 5 Sayı: 2, 154 - 163, 30.08.2020

Sevcan Avcı Işık , Aysel Abbasoğlu

Öz

Cerrahi ekipmanlar, modern cerrahinin ayrılmaz bir parçasıdır ve çok çeşitli cerrahi uzmanlık alanlarında rutin olarak kullanılmaktadır. Bu ekipmanlardan enerji bazlı aletler, içerisinde birçok zararlı kimyasal gaz, bakteri, virüs vb. partikülleri içeren cerrahi duman adı verilen bir gaz oluşturmaktadır. Ameliyathane hemşireleri ve cerrahi ekip ameliyatlarda bu zararlı dumana maruz kalmaktadırlar. Bu maruz kalma çalışanlarda solunum, gastrointestinal, nörolojik, kas iskelet gibi sistemleri etkileyerek birçok yan etki oluşturmaktadır. Güvenli ameliyathane ortamının oluşturulmasında uluslararası bazı sağlık kuruluşları cerrahi dumana maruz kalmanın ve yan etkilerin azaltılması için bazı öneriler geliştirmiştir. Bu derleme çalışmasında cerrahi duman, etkileri ve bu konuda alınması gereken önlemler verilmiştir.

Anahtar Kelimeler

Cerrahi duman, ameliyathane hemşireliği, mesleki maruz kalma

Kaynakça

• Alp, E., Bijl, D., Bleichrodt, R.P., Hansson, B., & Voss, A. (2006). Surgical smoke and infection control. The Journal of Hospital İnfections, 62(1), 1–5. doi:10.1016/j.jhin.2005.01.014
• Fencl J. L. (2017). Guideline Implementation: Surgical Smoke Safety. AORN Journal, 105(5), 488–497. https://doi.org/10.1016/j.aorn.2017.03.006
• Association of Surgical Technologists (2019a). AST Standards of Practice for Use of Electrosurgery. (2019, 11 Kasım) Erişim adresi: http://www.ast.org/uploadedFiles/Main_Site/Content/About_Us/Standard%20Electrosurgery.pdf
• Bratu, A.M., Petrus, M., Patachıa M., Mateı C., Popa, C., Banıta, S., & Dumıtras, D.C. (2015). Quantıtatıve Analysıs of Laser Surgıcal Smoke: Targeted Study on Sıx Toxıc Compounds. Romanian Journal of Physics, 60(1–2), 215–227.
• Bree, K., Barnhill, S., & Rundell, W. (2017). The Dangers of Electrosurgical Smoke to Operating Room Personnel A Review. Workplace Health & Safety, 65(11), 517-526. doi: 10.1177/2165079917691063. EORNA (2018). Recommendatıon on: Preventıon and Protectıon of Surgıcal Plume. (2019, 11 Kasım) Erişim adresi: https://eorna.eu/wp-content/uploads/2019/05/Prevention-and-Protection-of-Surgical-Plume-PNC-EORNA.pdf
• Fan, J.K, Chan, F.S., & Chu, K.M. (2009). Surgical smoke. Asian Journal of Surgery, 32(4), 253-7. doi: 10.1016/S1015-9584(09)60403-6.
• Gallagher, K., Dhinsa, B., & Miles, J. (2010). Electrosurgery. Surgery, 29, 70–72. doi: 10.1016/j.mpsur.2010.11.009.
• Hill, D.S., O’Neill, J.K., Powell R.J., & Oliver, D.W. (2012). Surgical smoke e 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. Journal of Plastic, Reconstructive & Aesthetic Surgery, 65(7), 911-6. doi: 10.1016/j.bjps.2012.02.012.
• Hohlfeld, I., Preissler, G., Jauch, K.W., Pitz, M., Nowak, D., Peters, A., & Wichmann, H.E. (2008). Surgical smoke and ultrafine particles. Journal of Occupational Medicine and Toxicology. 3(3), 31. doi: 10.1186/1745-6673-3-31.
• İlçe, A., Yuzden, G.E., & Yavuz van Giersbergen, M. (2017). The examination of problems experienced by nurses and doctors associated with exposure to surgical smoke and the necessary precautions. Journal of Clinical Nursing. 26 (11-12), 1555-1561. doi: 10.1111/jocn.13455.
• Kocher, G.J., Sesiaa, S.B., Lopez-Hilfikerb, F., & Schmid RA. (2018). Surgical smoke: still an underestimated health hazard in the operating theatre. European Journal of Cardio-Thoracic Surgery, 55(4), 626-631. doi: 10.1093/ejcts/ezy356.
• Lewin, J.M, Brauer, J.A., & Ostad, A. (2011). Surgical smoke and the dermatologist. Journal of the American Academy of Dermatology,65(3), 636-641. doi: 10.1016/j.jaad.2010.11.017.
• Massarweh, N.N., Cosgriff. N., & Slakey, P. (2006), Electrosurgery: history, principles, and current and future uses. Journal of American College of Surgeons, 202(3):520-30. DOI:10.1016/j.jamcollsurg.2005.11.017
• Miller, K.A., Siscovick, D.S., Sheppard, L., Shepherd, K., Sullivan, J.H., Anderson, G.L., & Kaufman, J.D. (2007). Long-term exposure to air pollution and incidence of cardiovascular events in women. The New England Journal of Medicine, 356, 447–458. Doi:10.1056/NEJMoa054409
• Mowbray, N., Ansell, J., Warren, N., Wall, P. & Torkington, J., (2013). Is surgical smoke harmful to theater staff? a systematic review, Surgical Endoscopy, 27(9),3100-7. doi: 10.1007/s00464-013-2940-5
• National Institute for Occupational Safety and Health (NIOSH). (2015) NIOSH Study Finds Healthcare Workers’ Exposure to Surgical Smoke Still Common (2019, 11 Kasım) Erişim adresi:https://www.cdc.gov/niosh/updates/upd-11-03-15.html
• National Institute for Occupational Safety and Health (NIOSH). (2016). Control of Smoke from Laser/Electric Surgical Procedures. NIOSH Pub. No. 96-128. (2019, 11 Kasım) Erişim adresi: http://www.cdc.gov/niosh/docs/ hazardcontrol/hc11.html
• Occupational Safety and Health Administration (OSHA) (2019a) Smoke Plume (2019, 11 Kasım)Erişimadresi: https://www.osha.gov/SLTC/etools/hospital/surgical/surgical.html#LaserPlume
• Occupational Safety and Health Administration (OSHA) (2019b). Laser/Electrosurgery Plume. (2019, 11 Kasım) Erişim adresi: https://www.osha.gov/SLTC/laserelectrosurgeryplume/
• Okgün Alcan, A., Yavuz Van Gıersbergen, M., Tanıl, V., Dinçarslan, G., Hepçivici, Z., Kurcan, Ç., Arıkan, E., & Dere, T. (2017). Bir Üniversite Hastanesinde Cerrahi Duman Riskleri ve Koruyucu Önlemlerin İncelenmesi. Ege Üniversitesi Hemşirelik Fakültesi Dergisi, 33 (2), 27-35
• Okoshi, K., Katsutoshi, K., · Kinoshita, K., Tomizawa, Y., Hasegawa, S., & Sakai, Y., (2015). Health risks associated with exposure to surgical smoke for surgeons and operation room personel. Surgery Today, 45(8):957-65. doi: 10.1007/s00595-014-1085-z.
• Romano, F., Gustén, J., Antonellis, S.D., & Joppolo, C.M. (2017). Electrosurgical Smoke: Ultrafine Particle Measurements andWork Environment Quality in Different Operating Theatres. International Journal of Environmental Research and Public Health, 14(2), 137. doi:10.3390/ijerph14020137
• Spearman, J, Tsavellas, G., & Nichols, P. (2007). Current attitudes and practices towards diathermy smoke. Annals of the Royal College of Surgeons of England, 89(2), 162-165. doi 10.1308/003588407X155752
• Steege, A.L., Boiano, J.M., & Sweeney, M.H. (2016). Second hand Smoke in the Operating Room? Precautionary Practices Lacking for Surgical Smoke. American Journal of Industrial Medicine, 59(11), 1020-1031. doi: 10.1002/ajim.22614.
• Watson, D.S. (2010). Surgical Smoke Evacuation During Laparoscopic Surgery. Patıent Safety Fırst, 92(3, 347-350. doi: 10.1016/j.aorn.2010.06.010
• Yavuz Van Giersbergen, M., Kaymakçı Ş., Özşaker, E., Okgün Alcan A., & Dirimeşe, E. (2019). Investigation of Surgical Smoke Symptoms and Preventive Measures in Turkish Operating Rooms. International Journal of Health Sciences & Research, 9(1), 138-244.