High-frequency electric knife smoke particles: An experimental study on factors influencing emission characteristics

During surgery, the use of a high-frequency electric knife produces smoke, which can be harmful to the health of indoor medical staff and patients. The quantity and particle size distribution of smoke particles produced by different tissues may vary. Understanding the release characteristics of these smoke particles is necessary to clarify their impact on the surgical environment and to seek effective smoke control methods. A previous comparative analysis of human and pig tissues revealed that they share similar water and fat compositions in certain anatomical regions. In this study, we investigated the emission characteristics of smoke particles from various tissues of pigs (skeletal muscle, liver, kidney, skin, and subcutaneous fat) under different operating powers of an electric knife. We measured the indoor particle number concentration (particle concentration), and estimated the PM2.5 mass concentration (PM2.5 concentration), particle size distribution, and emission rate of the smoke particles. The study obtained the particle emission rates of different tissues under different electric knife operating powers, results of which showed that (1) during the operation of the electric knife, mainly small particles below 1 μm are produced. Among them, particles of 0.3 μm were the most abundant, with a particle concentration level of up to 109 particles/m3, accounting for 85.17–97.64% of the total particle number, and as the particle size increased, the particle concentration and percentage decreased significantly. (2) The water and fat compositions of different tissues influenced the indoor particle concentration and emission rate of the smoke emitted by the electric knife. Among different tissues, subcutaneous fat tissue had the lowest particle concentration and emission rate. (3) The electric knife operating power mainly affected particles below 1 μm, and except for kidney tissue, the indoor concentration and emission rate of these particle sizes were positively correlated with the power. The experimental results can provide data reference for the use of high-frequency electric knives in surgeries involving different human tissues in the operating room.