Air contamination control in hybrid operating theatres. Particle content during different types of surgery with focus on diathermy

The paper presents the results of an experimental monitoring campaign carried out in a new-built Hybrid Operating Theater (OT). Fine Particles (FP) and Ultra Fine Particles (UFP) concentrations have been measured during 18 real surgery activities. The experimental campaign encompassed different types of surgeries, taking into account valuable info about use of Electro-Surgical Tools (ESTs), number of people inside OT and door openings frequency. Experimental results revealed a strict connection between the use of ESTs and the increase of fine and ultrafine particles concentration near surgical area due to surgical smoke which spreads out from the operating table towards the outer and less clean zone of the Hybrid OT. Tough it seems reasonable to assume that surgical smoke is potentially dangerous to both patients and personnel in operation rooms, both the generation rate and the exposure levels to UFP are, so far, quite unknown and undervalued. Our study shows that UFP in the surgical smoke generated by ESTs, and particularly by argon diathermy, affect the indoor air quality in OT.