Ameliyathane Çalışanlarında Cerrahi Dumana Maruz Kalmanın Semptomlar Üzerine Etkisi: Sistematik Derleme ve Meta Analiz
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DOI:
https://doi.org/10.5281/zenodo.7926831Anahtar Kelimeler:
Cerrahi Duman, Elektrocerrahi Dumanı, Mesleki Maruziyet, Mesleki Tehlike, ÖnlemÖzet
Amaç: Teknolojinin gelişmesiyle birlikte birçok alanda olduğu gibi ameliyathanelerde de ileri düzey ekipmanların kullanımı artmaktadır. Bu ekipmanlar kullanım açısından kolaylık sağlasa da ameliyathane çalışanları ve hastalar açısından bazı riskleri de barındırır. Cerrahi duman, elektrokoter, lazer, ultrasonik neşter, matkap, testere gibi ekipmanların ameliyat sırasında hemostaz, diseksiyon ya da eksizyon amaçlı kullanılması sonucu ortama salınan görünür özellikteki gazdır. Ameliyathane çalışanları bu durumdan olumsuz etkilenebilirler.
Gereç ve Yöntem: Bu sistematik derleme ve meta analizde, cerrahi dumana maruz kalan ameliyathane çalışanlarında dumandan korunmaya yönelik önlemlerin semptomlar üzerindeki etkisi belirlenmesi amaçlandı. 2010-2021 yılları arasında yayınlanan tanımlayıcı, kesitsel ve prospektif kohort çalışmalar değerlendirildi. 21 Aralık 2021 tarihinde CINAHL, MEDLINE, SCOPUS, Science Direct, Cochrane Library, Google Scholar veri tabanlarından uygun çalışmalar seçildi. Toplam 8 çalışmanın sonuçları (6 tanımlayıcı, 1 kesitsel, 1 prospektif kohort) birleştirildi.
Bulgular: Birleştirilmiş çalışmaların analizinde; cerrahi duman hakkında bilgi sahibi olma, tahliye cihazının varlığı, maruz kalma sıklığı ile baş ağrısı, bulantı, boğazda yanma, gözlerde yanma semptomlarının cerrahi dumana maruz kalma üzerinde pozitif yönde yüksek etki büyüklüğüne sahip olduğu bulundu. Cerrahi dumana yönelik önlem alma ve solunum değişiklikleri semptomu ise cerrahi dumana maruz kalma üzerinde negatif yönde etki büyüklüğüne sahip olduğu bulundu.
Sonuç: Cerrahi duman maruziyetine bağlı ameliyathane çalışanlarında baş ağrısı, bulantı, boğazda yanma ve gözlerde yanma bulguları maruziyetle doğru orantılı olarak arttığı, solunum değişikliklerinde ise azalma olduğu sonucu elde edildi. Ameliyathane çalışanlarının bilgi düzeyleri, önlem alma yöntemleri ve duman tahliye cihazları kullanımı arttıkça maruziyetin azaldığı, dumana maruz kalma sıklığı arttıkça semptomların da arttığı sonuçlarına ulaşıldı.
Referanslar
Alcan, AO, Van Giersbergen, MY, Tanıl, V, Dinçarslan, G, Hepçivici, Z, Kurcan, Ç, Dere, T. (2017). Examination of surgical smoke risks and protective measures in a university hospital. Journal of Ege University Faculty of Nursing, 33(2), 27-35.
Alver, E, Demirci, A, Özcimder, M. (2012). Polycyclic aromatic hydrocarbons and their effects on health. Mehmet Akif Ersoy University Journal of Science Institute 3(1), 45-52.
Asdornwised, U, Pipatkulchai, D, Damnin, S, Chinswangwatanakul, V, Boonsripitayanon, M, Tonklai, S. (2018). Recommended practices for the management of surgical smoke and bio-aerosols for perioperative nurses in Thailand. Journal of Perioperative Nursing, 31(1), 33-41.
Aydın, N, Kaya, U, Dal Yılmaz, Ü. (2021). The Effect of Surgical Smoke on Operating Room Staff. Medical Journal of Western Black Sea, 5(1), 80-85.
Ball, K. (2010). Surgical smoke evacuation guidelines: compliance among perioperative nurses. AORN journal, 92(2), e1-e23.
Benson, SM, Maskrey, JR, Nembhard, MD, Unice, KM, Shirley, MA, Panko, JM. (2019). Evaluation of personal exposure to surgical smoke generated from electrocautery instruments: a pilot study. Annals of Work Exposures and Health, 63(9), 990-1003.
Beswick, A, Evans, G. (2012). Evidence for exposure and harmful effects of diathermy plumes (surgical smoke). Buxton: Health & Safety Executive.
Bree, K, Barnhill, S, Rundell, W. (2017). The dangers of electrosurgical smoke to operating room personnel: a review. Workplace health & safety, 65(11), 517-526.
Canicoba, ARB, de Brito Poveda, V. (2021). Surgical Smoke and Biological Symptoms in Healthcare Professionals and Patients: A Systematic Review. Journal of PeriAnesthesia Nursing, 37(1), 130-136.
Claudio, CV, Ribeiro, RP, Martins, JT, Marziale, MHP, Solci, MC, Dalmas, JC. (2017). Polycyclic aromatic hydrocarbons produced by electrocautery smoke and the use of personal protective equipment 1. Revista latino-americana de enfermagem, 25.
Comprehensive meta-analysis (n.d.). Retrieved April 4, 2022, from https://www.meta analysis.com/pages/demo.php
Critical appraisal tools. JBI. (n.d.). Retrieved October 23, 2022, from https://jbi.global/critical-appraisal-tools
DerSimonian, R, Laird, N. (1986). Meta-analysis in clinical trials. Controlled clinical trials, 7(3), 177-188.
Dinçer S. (2014). Applied Meta-Analysis in Educational Sciences. (1st ed.). Ankara: Pegem Academy Publishing.
Edwards, BE, Reiman, RE. (2008). Results of a survey on current surgical smoke control practices. AORN journal, 87(4), 739-749.
Fox-Lewis, A, Allum, C, Vokes, D, Roberts, S. (2020). Human papillomavirus and surgical smoke: a systematic review. Occupational and Environmental Medicine, 77(12), 809-817.
Georgesen, C, Lipner, SR. (2018). Surgical smoke: risk assessment and mitigation strategies. Journal of the American Academy of Dermatology, 79(4), 746-755.
Hahn, KY, Kang, DW, Azman, ZAM, Kim, SY, Kim, SH. (2017). Removal of hazardous surgical smoke using a built-in-filter trocar: a study in laparoscopic rectal resection. Surgical Laparoscopy Endoscopy & Percutaneous Techniques, 27(5), 341-345.
Ilce, A, Yuzden, GE, Van Giersbergen, MY. (2017). The examination of problems experienced by nurses and doctors associated with exposure to surgical smoke and the necessary precautions. Journal of Clinical Nursing, 26(11-12), 1555-1561.
Keeley, L, Smalley, P. (2022). Occupational hazards of surgical smoke plume in the operating theatre. Surgical Plume Alliance 4-5.
Kılıç, S. (2015). Kappa test. Psychiatry and Behavioral Sciences, 5(3), 142.
Lindsey, C, Hutchinson, M, Mellor, G. (2015). The nature and hazards of diathermy plumes: a review. AORN journal, 101(4), 428-442.
Liu, N, Filipp, N, Wood, KB. (2020). The utility of local smoke evacuation in reducing surgical smoke exposure in spine surgery: a prospective self-controlled study. The Spine Journal, 20(2), 166-173.
Mowbray, N, Ansell, J, Warren, N, Wall, P, Torkington, J. (2013). Is surgical smoke harmful to theater staff? A systematic review. Surgical endoscopy, 27(9), 3100-3107.
Navarro-Meza, MC, González-Baltazar, R, Aldrete-Rodríguez, MG, Carmona-Navarro, DE, López- Cardona, MG. (2013). Síntomas respiratorios causados por el uso del electrocauterio en médicos en formación quirúrgica de un hospital de México. Revista Peruana de Medicina Experimental y Salud Pública, 30(1), 41-44.
Oberg, T, Brosseau, LM. (2008). Surgical mask filter and fit performance. American journal of infection control, 36(4), 276-282.
Olgun, Ş. (2020). Surgıcal smoke, precautıons and employee awareness. Journal of Awareness, 5(1), 65.
OSHA (The Occupational Safety and Health Administration). Laser/Electrosurgery Plume (n.d.). Retrieved October 21, 2022, from https://www.osha.gov/laser-electrosurgery-plume/standards
Pillinger, SH, Delbridge, L, Lewis, DR. (2003). Randomized clinical trial of suction versus standard clearance of the diathermy plume. Journal of British Surgery, 90(9), 1068-1071.
Saito, AC, Margatho, AS, Bieniek, AA, Stanganelli, NC, Ribeiro, RP. (2019). Signs and symptoms related to inhalation of surgical smoke in the nursing team. Escola Anna Nery, 23.
Smith, JD, MacDougall, CC, Johnstone, J, Copes, RA, Schwartz, B, Garber, GE. (2016). Effectiveness of N95 respirators versus surgical masks in protecting health care workers from acute respiratory infection: a systematic review and meta-analysis. Cmaj, 188(8), 567-574.
Spearman, J, Tsavellas, G, Nichols, P. (2007). Current attitudes and practices towards diathermy smoke. The Annals of the Royal College of Surgeons of England, 89(2), 162-165.
Stanganelli, NC, Bieniek, AA, Margatho, AS, Galdino, MJQ, Barbosa, KH, Ribeiro, RP. (2019). Inhalation of surgical smoke: cohort of signs and symptoms in residents. Acta Paulista de Enfermagem, 32, 382-389.
Stanley, K. (2019). Diathermy smoke shown to be hazardous, so why are we not protecting ourselves? Journal of perioperative practice, 29(10), 321-327.
Tseng, HS, Liu, SP, Uang, SN, Yang, LR, Lee, SC, Liu, YJ, Chen, DR. (2014). Cancer risk of incremental exposure to polycyclic aromatic hydrocarbons in electrocautery smoke for mastectomy personnel. World Journal of Surgical Oncology, 12(1), 1-8.
Usta, E, Aygin, D, Bozdemir, H, Uçar, N. (2019). The effects of surgical smoke in operating rooms and precautions for protection Journal of Health Science and Profession, 6(1), 17-24.
Ünver, S, Topçu, SY, Fındık, ÜY. (2016). Surgical smoke, me and my circle. International Journal of Caring Sciences, 9(2), 697-703.
Van Gestel, EA, Linssen, ES, Creta, M, Poels, K, Godderis, L, Weyler, JJ, ... Vanoirbeek, JA. (2020). Assessment of the absorbed dose after exposure to surgical smoke in an operating room. Toxicology Letters, 328, 45-51.
Van Giersbergen, MY, Alcan, AO, Kaymakci, S, Ozsaker, E, Dirimese, E. (2019). Investigation of surgical smoke symptoms and preventive measures in Turkish operating rooms. International Journal of Health Sciences and Research, 9(1), 138-144.
Van Giersbergen, M, Şahin Köze, B. (2022). Surgical Smoke. In Van Giersbergen, MY, Kaymakçı, Ş. (Eds.). Operating Room Nursing (pp. 295-308). İzmir: Turkish Society of Surgical and Operating Room Nurses.
Xie, W, Dumas, O, Varraso, R, Boggs, KM, Camargo, CA, Stokes, AC. (2021). Association of Occupational Exposure to Inhaled Agents in Operating Rooms with Incidence of Chronic Obstructive Pulmonary Disease among US Female Nurses. JAMA network open, 4(9), e2125749-e2125749.
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