The heat used in electrocautery causes cells to boil and explode, or simply
dry up, producing a gaseous by-product known as diathermy smoke.
This smoke may have mutagenic and carcinogenic potential, similar to
that of cigarette smoke (Spearman et al, 2007). A search of electronic
databases was performed and selected articles were reviewed using the
Critical Appraisal Skills Programme (CASP) tool to enable a review of
relevant material to be undertaken. The findings of the review identified 45
compounds, 9 of these were found to be hazardous when cross referenced
against the Control of Substances Hazardous to Health (COSHH) list of
approved workplace exposure limits (Health and Safety Executive (HSE),
2011) and 4 were carcinogens. This research indicates that the use of an
extraction device to remove smoke when using diathermy is best practice.
However, until more conclusive evidence is available on the actual health
risks of diathermy smoke, as opposed to the potential health risks, it will be
difficult for organisations that govern health and safety at work to create
legislation on the need to extract it from the operating theatre air
