Chemical Components of Smoke Produced From Versatile Training Tissue Models Using Electrocautery

INTRODUCTION: While exposure of surgeons and other staff to surgical smoke is an increasing health risk concern, there is a similar risk for users in surgical simulation and training. This study was undertaken to determine the chemical composition of smoke produced from a novel training model, Versatile Training Tissue (VTT), which is used for surgical simulation and training, and to compare this with smoke from a chemosynthetic model and porcine muscle and liver. METHODS: A variety of models (VTT, polyvinyl alcohol, porcine muscle and liver) were prepared and cauterized. Identification of chemical substances in smoke was performed using gas chromatography–mass spectrometry. Quantitative instrumental analysis was implemented with gas chromatography–mass spectrometry and high-performance liquid chromatography. A convenient analysis was performed with a general smoke tube kit. RESULTS: The main chemical components of smoke produced from VTT models include water and carbon dioxide. A small number of organic compounds were detected. Versatile Training Tissue models produced smoke with fewer compounds than smoke from a chemosynthetic model or porcine muscle. CONCLUSIONS: The concentration of organic compounds from VTT models is considered to be below relevant health risk limits and lower than from polyvinyl alcohol and porcine muscle models. Although porcine liver smoke contains less of the main organic compounds of concern than a KM, it contains potentially hazardous nitrile compounds that are absent in KM smoke. Therefore, surgical simulation and training with VTT models should be considered relatively safe for trainees.