Viable pathogen aerosols produced during laser dermatology surgery - a quantified analysis

The use of laser processes for surgical, medical and cosmetic procedures has been increasing with five hundred thousand workers exposed to laser surgical smoke per year. The use of lasers introduces direct beam hazards into the environment but also generates unique hazards such as material ejected from the laser process. Within this material can be potentially harmful particulate when inhaled by humans, accompanying this particulate is a foul unwanted odour. Along with the generation of these particles it is extremely possible for viable biological organisms to be generated with the particulate. Airborne particulate matter or bio-aerosols are not just a hazard to the patient, but also to other people in the environment around the laser process. The aim of this paper is to investigate and quantify the aerosol danger to both patients and operators when utilising lasers within surgical procedures, while suggesting a suitable initial solution. The tailored research for this aim will focus on whether a suitable extraction system can be developed and the effects that different types of lasers have on the size and visuals of any particulate generated. To determine whether there is a risk of infection and to ascertain the level of infection control, the possibility of viable bio-aerosols being detected after a laser process should be considered. The experiments are split into 3 sections; section 1 is the testing of the extraction system using a smoke generation system to ascertain visual proof of a functioning extraction system, section 2 is the testing of the effect of laser irradiance on the tissue simulant to determine the effect of varying laser types on the particulate generated and section 3 is the generation and measurement of bio-aerosols with the use of bio markers to test for survival of laser processing and transmission

The design of medical laser surgery dermatology handpieces for radiation control and direct extraction of infectious laser generated plume

Surgical skin treatments such as; laser ablation, laser scalpels, hair removal, tattooed removal etc can all generate direct and secondary optical radiation hazards, however, because they are designed to intentionally destroy human tissue, they also generate gaseous and particulate emissions. This second family often referred to as; surgical smoke, surgical smoke plume and surgical fume, have now been identified as producing viable bio-active aerosols, these by-products now pose infectious hazards to the patient and staff of the operating room. Local extraction is sometimes used to try and reduce the airborne concentration of these byproducts though in virtually all cases the smell of the process is detectable by all. The optical radiation hazard usually dictates the wearing of protective eyewear to provide some level of personal protection. A major health concern to all medical and cosmetic facilities is that of infection control. Surgical smoke is usually overlooked as a source of infection within the operating environment and it has been known since the mid-1980s that the particulate can carry with it live pathogens from the patient which can now be in skin contact or respired by the operating staff. A paper presented by the authors in the Medical Session here at ILSC provides possibly the first quantitative analysis of the hazards the surgeon and other staff are subject to. This paper examines the practical limitations of the existing approaches and provides some simple practical control measures that provide complete radiation containment as well as enable complete particulate and gas extraction without any reliance on any form of personal protection for the patient and operating staff. These designs have now been tested and are shown to offer 100% effective plume extraction and radiation containment