Surgical field fire and skin burns caused by alcohol-based skin preparation

Patel, Rajan B.; Chavda, KD; Hukkeri, Santosh

doi:10.4103/0974-2700.66530

Cited by 18 publications

(5 citation statements)

References 3 publications

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“…Several case reports identifying alcohol-based skin preparations as a fuel source in surgical fires have been published. [3][4][5] Despite these data, we were unable to demonstrate flammability of isopropyl alcohol using electrofulguration and electrodesiccation. To further explore why isopropyl alcohol failed to ignite under tested conditions, we also evaluated the flammability of gauze dampened with isopropyl alcohol and water, and gauze only partially dampened with isopropyl alcohol.…”

Section: Discussioncontrasting

confidence: 56%

Flammability of topical preparations and surgical dressings in cutaneous and laser surgery: A controlled simulation study

Arefiev¹,

Warycha²,

Whiting³

et al. 2012

Journal of the American Academy of Dermatology

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Section: Discussioncontrasting

confidence: 56%

Flammability of topical preparations and surgical dressings in cutaneous and laser surgery: A controlled simulation study

Arefiev¹,

Warycha²,

Whiting³

et al. 2012

Journal of the American Academy of Dermatology

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“…13 Multiple studies have described OR fire resulting from alcohol-based skin preparations. [16][17][18][19][20] Use of supplemental oxygen through nasal cannula or face mask, particularly in head and neck surgery, augments this risk and can even lead to ignition of objects that are considered to be "nonflammable" such as endotracheal tubes and plastic face masks. 21,22 Although the self-limited flash flames that were commonly generated in this study are unlikely to cause significant patient harm, even a small increase in the local oxygen content can convert these flash flames into a spreading fire or explosion with devastating consequences.…”

Section: Discussionmentioning

confidence: 99%

Surgical Smoke Evacuators Reduce the Risk of Fires From Alcohol-Based Skin Preparations

Carmichael¹,

Samuels²,

Wikiel³

et al. 2019

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Surgical smoke evacuators may reduce the concentration of alcohol vapors from skin preparations at the site of electrosurgical device activation, decreasing operating room fire risk. Our aim was to compare the incidence of flames with and without smoke evacuation in a porcine ex vivo model. A monopolar device was activated after application of either 70% isopropyl alcohol/2% chlorhexidine gluconate (CHG-IPA) or 74% isopropyl alcohol/0.7% iodine povacrylex (iodine-IPA) skin preparations. No suction was compared with standard wall suction and 2 monopolar devices with built-in smoke evacuators. Flames were generated in 60% of CHG-IPA and 47% of iodine-IPA tests without suction. Wall suction did not significantly reduce fires (CHG-IPA 43% vs. 60%, P = 0.30; iodine-IPA 57% vs. 47%, P = 0.61). Use of both smoke evacuation devices reduced fires for CHG-IPA (17% vs. 60%, P = 0.001 and 20% vs. 60%, P = 0.004) but not for iodine-IPA. Smoke evacuation devices reduce fire risk when used with a chlorhexidine-alcohol skin preparation.

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“…Unfortunately, also most commercial chlorhexidine solutions contain alcohol, and their flammability is in direct proportion to their alcohol concentration [24]. Although some case reports identifying alcohol-based skin preparations as a fuel source in surgical fires have been published in human medical literature [41-43], a recent study was unable to demonstrate flammability of isopropyl alcohol exposed to electrofulguration in experimental settings [44]. Conversely, when materials in the study were poured with chlorhexidine gluconate under saturated and damp conditions produced a spark and associated mild to moderate char [44].…”

Section: Discussionmentioning

confidence: 99%

Fire ignition during laser surgery in pet rodents

Collarile¹,

Girolamo²,

Nardini³

et al. 2012

BMC Vet Res

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BackgroundLaser surgery is an attractive alternative to other means of section device in terms of tissue inflammation and interaction, which has been extensively used in human and veterinary medicine. Although accidental ignition during laser surgeries is sporadically reported in human medical literature, to the authors’ knowledge this is the first report regarding laser-dependent fire ignition during surgery in veterinary medicine.Case presentationTwo rodents, a 13-month old, 27-gram, male pet mouse (Mus musculus) and a 1-year old, female Russian hamster (Phodopus sungorus), underwent surgical removal of masses with diode laser. During the surgical procedures fires ignited from the face masks. The mouse presented severe burns on the head and both forelimbs, it was hospitalized and approximately 2 months after surgery burns were resolved. The hamster presented severe burns on the face and the proximal regions of the body. At 72 hours from the accident the hamster was euthanized.ConclusionThe present report suggests that fire ignition is a potential life-threatening complication of laser surgery in non-intubated rodents maintained under volatile anesthesia. High oxygen concentrations, the presence of combustible, and the narrowness of the surgical field with the face mask during laser surgery on rodents are risk factors for fire ignition.

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Surgical field fire and skin burns caused by alcohol-based skin preparation

Cited by 18 publications

References 3 publications

Flammability of topical preparations and surgical dressings in cutaneous and laser surgery: A controlled simulation study

Flammability of topical preparations and surgical dressings in cutaneous and laser surgery: A controlled simulation study

Surgical Smoke Evacuators Reduce the Risk of Fires From Alcohol-Based Skin Preparations

Fire ignition during laser surgery in pet rodents

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