When you hear about haze, I believe that everyone will not be unfamiliar with it, and the image of smog will quickly come to mind, making it difficult to breathe and feeling a sense of suffocating fear. We all know that one of the main substances that form haze is fine particulate matter (PM2.5).

With the development of clean technology, ordinary operating rooms have been transformed into clean operating rooms to ensure clean air during surgery and reduce the rate of post-operative infection. However, even with this clean technology, the confined nature of the clean operating room, the rapid development of new medical equipment, including the widespread use of electrosurgical equipment will inevitably produce harmful fumes, so that the operating room also appeared in the "haze".

01, surgical electrosurgical smoke components and hazards
As early as 1996, the United States has developed a relevant operating room smoke prevention system. Association of Operating Room Nurses (AORN) began to call: do not become a victim of surgical smoke [2]. Surgical electrosurgical smoke consists mainly of 95% water or steam and 5% tissue cell residue and chemical components, mainly including active cancerous cells, pathogens and viruses, toxic and harmful chemicals. Active cancerous cells and viruses are infectious.

02, electrosurgical equipment principle and role
Since there are many types of electrosurgical equipment, the high-frequency electrosurgical knife, which is most commonly used in surgical procedures, is introduced here as an example. The high-frequency scalpel is an electrosurgical instrument that replaces the mechanical scalpel for tissue cutting. It heats the tissue when it comes into contact with the muscle through the high-frequency and high-voltage current generated by the effective electrode tip, realizing the separation and coagulation of the body tissue, and playing the purpose of cutting and hemostasis.

03, surgical electrosurgical smoke protection measures
1、Improve the awareness of protection   
Health care workers should fully understand the hazards of surgical smoke, strengthen the awareness of personal protection, turn passive protection into active protection.
2, focus on personal protection  
Correctly wear a good surgical mask, surgical mask as much as possible with the face close fit. Some health care workers do not pay attention to the protective effect of masks, wear masks at random.
3、Reduce the generation of smoke  
Compared with the electric knife, ultrasonic knife is relatively safe, produces less harmful smoke, under the condition of trying to use ultrasonic knife. The use of surgical electrical equipment, power settings should not be too large, according to the various types of surgery to correctly adjust the surgical mode, and strive to obtain the maximum efficacy of the minimum output power. When the working surface of surgical instruments adheres to tissues, blood and other easily coked substances, it is easier to produce a large amount of smoke.
4、Strengthen the smoke discharge  
The timely discharge of smoke in the operating room depends on good air purification and negative pressure suction system.
(1) The Association of Operating Room Nurses suggests that, when using electrosurgical equipment, the operating room should use a centralized smoke exhaust system to ensure that the requirements of laminar flow operating room, the operating room should be at least 15 times / h for air replacement, and each time it should be replaced with 20% of the filtered fresh air.
(2) Mobile smoke evacuation systems are another important means of effective smoke evacuation, ensuring effective suction without interfering with the surgeon's operation.
5. Development of smoking devices  
There is a design of 14G bladder catheter connected to the suction device, the catheter attached to the electrosurgical pen, the front end of which is 2cm away from the tip of the electrosurgical pen, which can reduce smoke by more than 95%, this design is low-cost and safe and effective; in laparoscopy, there is a design of a disposable infusion tube smoke removal method, connecting the infusion tube with the puncture device exhaust valve.