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Mask provides effective, cheap protection from hazardous electrocautery plumes

REPORTING FROM THE ACMS ANNUAL MEETING

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She placed N95 masks, basic procedural masks, and laser masks over the probes of two commercially available airborne particle counters, one capturing ultrafine particles less than 1 mcm in size, the other for particles greater than 2.5 mcm. She sealed the mask edges to the probes with tape to eliminate loose fit as a confounder. Then she and her coinvestigators performed monopolar electrocautery on discarded surgical Burow triangle tissue specimens to order to create smoke plumes and test mask effectiveness. This process was repeated five times for each type of mask, as well as for a no-mask control condition.

The N95 masks were the clear winner, particularly when it came to filtering the ultrafine particles, which are of greatest concern because they remain suspended in air longer and penetrate deeper into the respiratory tract than larger particles. The N95 masks proved superior to procedural masks, which in turn were significantly more effective than the laser masks. The differences between mask performance for larger particle filtration were smaller, although the N95 remained number one. She noted that the study results probably underestimate the true filtration efficacy of N95 masks, since they form a tighter seal with the face in clinical practice than with the other two mask types.

Mask self-protection “is easily applicable in your own practice, and it meets NIOSH-recommended [National Institute for Occupational Safety and Health] standards for safety in the workplace,” the dermatologist noted.

In the next phase of her research, she plans to evaluate the optimal technology and techniques of smoke evacuation in the surgical suite. That’s an attractive method because it protects everyone in the room, not just the surgeon. And while the practitioner survey indicates this technology isn’t widely used by dermatologic surgeons on a routine basis at present, that could change, particularly in the current era in which patient-reported outcomes and satisfaction surveys have taken on added weight.