A brief historical review of non-anaesthetic causes of fires and explosions in the operating room

Macdonald, Andrew

doi:10.1093/bja/73.6.847

Cited by 83 publications

(52 citation statements)

References 62 publications

(67 reference statements)

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“…First, it has been recommended that [1] 10% povidone-iodine in alcohol solution, [2] thimerosal in 50% alcohol solution, [3] 70% chlorhexidine hand rub, and [4] methanol or ethanol should not be used for skin cleaning in the operative field. Second, when using electro-surgical equipment, minimize the time it is used and use non-flammable equipment instead of flammable equipment.…”

Section: Discussionmentioning

confidence: 99%

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A patient who was burned in the operative field: a case report

Chung¹,

Lee²,

Kim³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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Ameliyat alanı yangınları oldukça nadirdir. Yine de, bir felaket, hemen hemen her türlü cerrahiyi güçleştirebilir. Ameliyat alanı yangınlarının çoğunluğu, oksijenden zengin bir ortamda alkol bazlı cerrahiye hazırlama solüsyonları-nın, elektrikli cerrahi ekipmanın veya kolay tutuşan kumaş-ların kullanılmasından kaynaklanmaktadır. Biz, over kisti ve uterin miyomları nedeniyle jinekolojik cerrahi geçirir-ken alev yanığına maruz kalan hastayı sunuyoruz.Anahtar Sözcükler: Alev; alev yanığı; ameliyathane; alkol bazlı cerrahi hazırlık solüsyonları; elektrikli cerrahi ekipman.Operating room fires occur very rarely. Nevertheless, a disaster can complicate almost any kind of surgery. The majority of operating room fires result from the use of alcohol-based surgical preparation solutions, electro-surgical equipment, or flammable drapes in an oxygen-rich environment. We report a patient with an ovarian cyst and uterine myomas who suffered a flame burn while undergoing gynecological surgery.

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Section: Discussionmentioning

confidence: 99%

“…[1] Operating room fires and burns are relatively rare, but such disasters can complicate almost any surgical procedure. In the United States, approximately 100 operating room fires are reported each year, although burns to the patient are not counted.…”

mentioning

confidence: 99%

A patient who was burned in the operative field: a case report

Chung¹,

Lee²,

Kim³

et al. 2012

Ulus Travma Acil Cerrahi Derg

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“…Fire risks, through the ignition of tubing, some anaesthetic gases or chemicals (eg alcoholic disinfectants), should be identifi ed and avoided. [26][27][28][29][30] In addition, the products of tissue ablation (plume) represent a considerable hazard that can affect the clinician, auxiliary personnel and the patient. Suitable fi ne mesh face masks specifi c to surgical laser use, gloves and high-speed suction aspiration must be used to control the spread of all laser tissue ablation products (see Fig.…”

Section: Non-beam Risksmentioning

confidence: 99%

Laser regulation and safety in general dental practice

Parker

2007

Br Dent J

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“…In ophthalmic practice the incidence of surgical fires reported is very rare despite the presence of oxygen and the use of electrocautery [12].…”

Section: Introductionmentioning

confidence: 99%

“…Experimental studies have shown that hot wire cautery or diathermy generates enough heat to ignite all alcohol based antiseptics even if these contain as little as 20% alcohol [3]. Fuels are abundant in the operative field that include prep solutions, drapes, sponges, endotracheal tubes, petroleum based ointments, tinctures, as well as many others [12]. In the presence of a high oxygen environment, all of these substances can burst into flames and burn intensely.…”

mentioning

confidence: 99%

Mascara: A Cause of Thermal Burn after Cautery for Eye Lid Lesion Excision; A Case Report

Raqqad¹,

Liu²

2010

J Clinic Experiment Ophthalmol

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IntroductionA surgical fire is a rare but potential risk in surgical practice. Fire has been recognised as a potential complication of surgery for many years [1]. Fire occurs when the three elements of the fire triad, fuel, oxidiser and ignition coincide. Surgical fires are unusual in the absence of an oxygen-enriched atmosphere. The ignition source is most commonly diathermy but lasers carry a relatively greater risk. The factors that may initiate these fires are many and include alcohol based surgical prep solutions, electrosurgical equipment, and flammable drapes [2][3][4]6,10].The majority of fires occur during head and neck surgery. In ophthalmic practice the incidence of surgical fires reported is very rare despite the presence of oxygen and the use of electrocautery [12]. PurposeWe describe a case of surgical flash fire causing thermal burn of eye lashes, eyelid skin and eye brow hair in a patient who had some residual mascara on her lashes while cautery was applied for an eyelid lesion after excision in clinical setting and in the absence of oxygen rich environment. Case reportWe report a 38 year old lady who had a small papilloma on the right upper eyelid skin for which she underwent excision. Surgical techniqueThe area was exposed and cleaned with povidine iodine. After the iodine was wiped off the area was left to dry for a minute and a small forceps was used to lift the papilloma. A 15 degree blade was then used to cut it from its base. Disposable pencil cautery was used to stop the bleeding by applying it onto the base of the lesion. A sudden blue flame of fire then caught the eyelashes, swept through the skin and burnt the eye brow hair successively. It also caused the surgical gloves used by the surgeon to be burnt and to scald his finger tips underneath. Cautery was abandoned immediately.Cold water was applied to the area, antibiotic ointment was given and the patient was examined at the slit-lamp. No conjunctival, corneal or any other ocular injury was noted and the patient was reviewed after one week and then after one month. By then the burns had recovered and all lashes and brown hair had re-grown. DiscussionCautery can be applied in several clinical settings in order to ensure haemostasis after excision of small lesions. Surgical fires have been described in several occasions within the operating room and in an oxygen-rich environment. Several igniting factors have been described and review of surgical flammable materials and safety issues in the operating room can be found in literature [2]. DiscussionThe fire triangle is a useful construct that describes the three elements necessary for initiation of a fire i.e. heat, fuel and an oxidizer [5,6,8,9,11]. spark from electrosurgical unit usually acts as the heat source. Experimental studies have shown that hot wire cautery or diathermy generates enough heat to ignite all alcohol based antiseptics even if these contain as little as 20% alcohol [3]. Fuels are abundant in the operative field that include prep solutions, drapes, sponges, endotrach...

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A brief historical review of non-anaesthetic causes of fires and explosions in the operating room

Cited by 83 publications

References 62 publications

A patient who was burned in the operative field: a case report

A patient who was burned in the operative field: a case report

Laser regulation and safety in general dental practice

Mascara: A Cause of Thermal Burn after Cautery for Eye Lid Lesion Excision; A Case Report

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