What You Need to Know About Surgical Smoke Plume

Republish Date: May 12, 2025

Original Publish Date: February 1, 2016

According to a review by the Journal of Hospital Infection¹, over 500,000 people are exposed to surgical smoke plume each year. These smoke plume can be the byproduct of electrosurgical or laser procedures and carry many potential hazards to surgeons, operating room staff and the patients they care for. This is why the presence of devices which remove surgical smoke from the air has become increasingly important as electrosurgical procedures have become more common.

The Composition of Surgical Smoke

Surgical smoke plumes are composed of 95% water and 5% other matter. The “other matter” is what poses threats to both surgical personnel and the patients they’re treating. Chemically, surgical smoke contains over 80 toxic chemicals and by-products. Some of the identified chemicals are:

• Hydrogen cynanide, a neurotoxin used in chemical warfare

• Toluene, a known carcinogen similar to paint thinner

• Perchloroethylene, a main component in dry cleaning fluid

• Benzene, a known carcinogen

• Formaldehyde, used in embalming fluid and to preserve surgical specimens

• Ethylbenzene, which is used to manufacture Styrofoam

Electrocautery also generates carbon monoxide, a dangerous gas which can cause headaches and nausea but which goes undetected by a pulse oximeter.

The Dangers of Surgical Smoke Plume

Surgical smoke plumes cause side effects ranging in severity from mildly irritating to potentially dangerous. They can include:

• respiratory irritation with acute and chronic inflammatory changes

• hypoxia with dizziness, lightheadedness and headache

• eye irritation and tearing

• sneezing

• throat irritation

• nausea

• vomiting

• potential carcinogens

• skin irritation

The smoke generated during electrosurgery or laser applications irritates the lungs to the point where, according to an article written for the Association for Professionals in Infection Control and Epidemiology, burning one gram of tissue has the same effect on them as does three to six cigarettes. The particles create a dust similar to coal dust, with many particles smaller than 0.3 microns which have the ability to deposit in the terminal alveoli.

Since 95% of surgical smoke is composed of water, it is the perfect carrier for bacteria and viruses which carry infectious diseases.

The Bovie Smoke Shark II Smoke Evacuation System

The perfect solution to the problem of surgical smoke plume is the Bovie Smoke Shark II. It’s a portable, lightweight and easy-to-use smoke evacuator which provides smoke evacuation versatility while meeting the standards outlined by regulatory agencies. Its four-stage filtration system captures all particulate matter and chemical toxins in the smoke plume as follows:

1. A pre-filter which captures and removes particulate matter and casual fluid

2. Ultra Low Penetration Air (ULPA) grade filter which captures particulates and micro-organisms down to a size of 0.1 – 0.2 microns with 99.9999% efficiency (this is 100 times finer filtration than the HEPA standard)

3. Highest grade virgin activated charcoal, specially designed to remove and absorb toxic organic gases and provide optimal odor removal

4. An expanded foam which traps activated carbon fines and keeps them from leaving the filter

The Smoke Shark II has three operating speeds which affect the filter life accordingly – the Low Flow Setting offers 35 hours of filter life, Medium Flow offers 24 hours, and High Flow offers 18 hours.

The Smoke Shark II also accepts three different sizes of tubing, which affect the maximum airflow. Plus, it’s ultra-quiet, adding very little ambient noise to the operating room at only 55.0 dBa at maximum.

Reducing the risk of the inhalation of surgical smoke should be a priority for any surgical or medical practice. This is why Bovie’s Smoke Shark™ II Smoke Evacuation System is the perfect addition to any operating room or physician office.