Toxic plumes, the contents of which include viruses, aerosols, and volatile organic compounds, are produced by vaporization of tissue by electrocautery or laser surgery (Dermatol 2021;62:37-40). Inhalation carries infectious, respiratory, and cardiovascular risks. Surgical masks provide some protection, but N95 respirators are even more protective (J Hosp Infect 2006;64:278-81).
OR air should be filtered through a high-efficiency particulate air filtration (HEPA) system. An air suction/scavenging system reduces exposure to viruses and other toxic elements of the plume. Air drawn through the scavenging system should be filtered either through a HEPA filter (99.97 efficacy at 0.3 μm) or (preferably) an ultra-low penetration air filter (99.9995% efficacy at 0.12 μm).
Toxic volatile gases readily pass through HEPA or ULPA filters but can be removed with activated carbon filters. ORs should be maintained at pressures below atmospheric to ensure that the toxic fumes leave through exhaust vents and not...