Reducing dust using the electrocautery pencil with suction combined with the infusion catheter in mastectomy.

The dust from the vaporized tissue released during a mastectomy presents a hazard to the patients and the operating room personnel. More dust has been noted using the conventional electrocautery pencil in dissecting breast tissue than with the metal knife used in the past. It is very important to reduce the hazardous dust released during mastectomy. For this study 80 patients undergoing mastectomy for breast cancer from March to June 2001 were divided into two groups: 1) those whose dissections were performed with a combination of an electrocautery pencil and suction with an intravenous infusion catheter (40 cases) and 2) those whose dissections were performed with the conventional method in which the electrocautery pencil was handled by the surgeon and the metal suction tube was used separately by an assistant (40 cases). During mastectomy the personal air sampler was affixed to the operator's neck to collect the dust from the vaporized tissue. The concentrations of the total dust were significantly lower in the combined electrocautery-suction method (mean 5.56 +/- 3.26 microg/m3) than in the conventional method (mean 34.81 +/- 4.83 microg/m3) during mastectomy (P < 0.05). Although the operating time and blood loss were less in the combined method than in the conventional method this difference was not statistically significant (P > 0.05). The combined method of using the electrocautery pencil for dissecting breast tissue along with the intravenous infusion catheter reduced the concentrations of the total dust from the vaporized tissue plume. Furthermore this method reduces the hazards of dust to the surgeons and operating room personnel. Additionally the cost of this combined method is lower than that of the conventional method.