Patients and dermatologists alike are put at risk by the plume produced by electrosurgical procedures. Therefore, it is important to evaluate the relative particle concentration produced by the various energy devices used in dermatologic surgery. Human tissue samples were used in a closed chamber experiment involving five surgical procedures. The concentrations of aerosolized particles were measured across seven particle sizes (0.3, 0.5, 0.7, 1, 2.5, 5, and 10 μm) using a particle counter stationed at a fixed distance of 20 cm from the sample. Electrocautery, electrodesiccation, electrofulguration, and bipolar electrocoagulation produced smaller particle concentrations than monopolar electrocoagulation. Compared to monopolar electrocoagulation, bipolar electrocoagulation produced a significant decrease in particle size, with 80 times fewer 0.3 μm particles and 98 times fewer 0.5 μm particles. Particles between 0.3 and 0.5 μm in size were most abundantly produced across all electrosurgical procedures. The particulate matter concentration was lowest when bipolar electrocoagulation was used. Given the potentially harmful effects of the surgical plume, using bipolar forceps provides surgeons with a more secure means of performing electrical surgery on patients.

Source: journals.lww.com/dermatologicsurgery/Abstract/2022/09000/Plume_Generated_by_Different_Electrosurgical.10.aspx