MEDAP FUMOVAC 700

Powerful, compact
smoke evacuation unit
for the OR

Normal ventilation in the operating room exchanges the air up to 24 times per hour. This is not sufficient to remove the locally generated aerosols and gases quickly enough to prevent them from posing a danger to the OR team.

No. These systems reach the following capacities:

• Central gas supply — vacuum: seldom over 50 l/min
• Central gas supply — compressed air: seldom over 40 l/min
• Electrical surgical aspirator — seldom over 60 l/min

Studies have found that a capacity of least 400–600 l/min is necessary for effective smoke evacuation.

In addition, electrical surgical aspirators and suctioning with compressed air via the central gas supply release the air into the operating room again. Since there is no odour filter, the unpleasant odours return to the operating room.

Finally, surgical smoke can also damage the motor in electrical surgical aspirators and the complex mechanisms in tapping units if no special smoke evacuation filter is installed.

It will always be very difficult to prove that certain biological substances were transmitted to a person during a particular operation and that such material caused a certain disease in that person possibly many years later.

Toxicological studies have identified erythrocytes and living cell material as well as biological contaminants, such as viruses, bacteria, mycobacteria, and fungi. Even viral DNA and HIV DNA have been found in tubes used for smoke evacuation and could be cultivated. In addition, inorganic and organic substances, such as carbon monoxide, benzene, formaldehyde, toluene, and carcinogenic toxins, have been detected.

The Technical Rules for Hazardous Substances in medical care facilities (TRGS 525) of the Federal Institute for Occupational Safety and Health in Germany (Bundesanstalt für Arbeitsschutz und Arbeitsmedizin) in the version of September 2014 explicitly specify the hazards of surgical smoke in chapter 8.1 and define the appropriate protective measures.

There are many studies in which over 41 different chemical substances have been found whose carcinogenic or teratogenic effect in animals and/or humans have either already been proven or suspected. Toxicological studies have identified erythrocytes and living cell material as well as biological contaminants such as viruses (e.g. papillomaviruses), proteins, prions (BSE agent), bacteria, mycobacteria, and fungi. Even viral DNA and HIV DNA have been found in tubes used for smoke evacuation and could be cultivated.

Since 90 percent of the particles present in surgical smoke are smaller than 0.3–0.5 μm, they can penetrate deep into the alveoli of the OR team and even be absorbed by the blood. This can result in pulmonary inflammations and is presumably even carcinogenic, the risk of infection via the mucous membranes and airways being higher with low-temperature vapours since temperature-resistant germs are not killed.

Frequently, the particles cause irritation of the throat and nose as well as respiratory problems or allergic reactions. The rule is: the smaller the particles, the more dangerous they are from a chemical perspective; the larger the particles, the more dangerous they are from a biological perspective. Studies have also found that vapourised tissue and cigarette smoke have similar toxic components ranging from polycyclic, aromatic hydrocarbons, cresols and phenols to hydrogen cyanides, acrolein, formaldehyde, and carbon monoxide.

During laser and HF surgery, cutting and coagulation produce smoke with unpleasant odours. This deteriorates the air quality in the operating room to such an extent that the OR team can experience headaches and nausea. Especially the organic components in the smoke are known to cause tiredness and a feeling of faintness as well as cardiac arrhythmia and breathing difficulties.