BACKGROUND: Operating room fires are "never events" that remain an under-reported source of devastating complications. One common set-up that promotes fires is the use of surgical skin preparations combined with electrosurgery and oxygen. Limited data exist examining the incidence of fires and surgical skin preparations. STUDY DESIGN: A standardized, ex vivo model was created with a 15 × 15 cm section of clipped porcine skin. An electrosurgical "Bovie" pencil was activated for 2 seconds on 30 Watts coagulation mode in 21% oxygen (room air), both immediately and 3 minutes after skin preparation application. Skin preparations with and without alcohol were tested, and were applied with and without pooling. Alcohol-based skin preparations included 70% isopropyl alcohol (IPA) with 2% chlorhexidine gluconate, 74% IPA with 0.7% iodine povacrylex, and plain 70% IPA. RESULTS: No fires occurred with nonalcohol-based preparations (p < 0.001 vs alcohol-based preparations). Alcohol-based preparations caused flash flames at 0 minutes in 22% (13 of 60) and at 3 minutes in 10% (6 of 60) of tests. When examining pooling of alcohol-based preparations, fires occurred in 38% (23 of 60) at 0 minutes and 27% (16 of 60) at 3 minutes. CONCLUSIONS: Alcohol-based skin preparations fuel operating room fires in common clinical scenarios. Following manufacturer guidelines and allowing 3 minutes for drying, surgical fires were still created in 1 in 10 cases without pooling and more than one-quarter of cases with pooling. Surgeons can decrease the risk of an operating room fire by using nonalcohol-based skin preparations or avoiding pooling of the preparation solution. Published by Elsevier Inc.
BACKGROUND: Operating room fires are "never events" that remain an under-reported source of devastating complications. One common set-up that promotes fires is the use of surgical skin preparations combined with electrosurgery and oxygen. Limited data exist examining the incidence of fires and surgical skin preparations. STUDY DESIGN: A standardized, ex vivo model was created with a 15 × 15 cm section of clipped porcine skin. An electrosurgical "Bovie" pencil was activated for 2 seconds on 30 Watts coagulation mode in 21% oxygen (room air), both immediately and 3 minutes after skin preparation application. Skin preparations with and without alcohol were tested, and were applied with and without pooling. Alcohol-based skin preparations included 70% isopropyl alcohol (IPA) with 2% chlorhexidine gluconate, 74% IPA with 0.7% iodinepovacrylex, and plain 70% IPA. RESULTS: No fires occurred with nonalcohol-based preparations (p < 0.001 vs alcohol-based preparations). Alcohol-based preparations caused flash flames at 0 minutes in 22% (13 of 60) and at 3 minutes in 10% (6 of 60) of tests. When examining pooling of alcohol-based preparations, fires occurred in 38% (23 of 60) at 0 minutes and 27% (16 of 60) at 3 minutes. CONCLUSIONS:Alcohol-based skin preparations fuel operating room fires in common clinical scenarios. Following manufacturer guidelines and allowing 3 minutes for drying, surgical fires were still created in 1 in 10 cases without pooling and more than one-quarter of cases with pooling. Surgeons can decrease the risk of an operating room fire by using nonalcohol-based skin preparations or avoiding pooling of the preparation solution. Published by Elsevier Inc.
Authors: Jason M Samuels; Heather Carmichael; Krzysztof J Wikiel; Thomas N Robinson; Carlton C Barnett; Teresa S Jones; Edward L Jones Journal: Surg Endosc Date: 2019-06-20 Impact factor: 4.584
Authors: P Fuchshuber; S Schwaitzberg; D Jones; S B Jones; L Feldman; M Munro; T Robinson; G Purcell-Jackson; D Mikami; A Madani; M Brunt; B Dunkin; C Gugliemi; L Groah; R Lim; J Mischna; C R Voyles Journal: Surg Endosc Date: 2017-12-07 Impact factor: 4.584
Authors: Monika K Huss; Kerriann M Casey; Jing Hu; Roberta C Moorhead; Helen H Chum Journal: J Am Assoc Lab Anim Sci Date: 2019-11-21 Impact factor: 1.232
Authors: Alessandro Boscarelli; Simone Frediani; Silvia Ceccanti; Alice Cervellone; Maria Vittoria Pesce; Denis A Cozzi Journal: Urol Case Rep Date: 2017-09-05
Authors: Abbie V Viscardi; Charley A Cull; Michael D Kleinhenz; Shawnee Montgomery; Andrew Curtis; Kelly Lechtenberg; Johann F Coetzee Journal: J Anim Sci Date: 2020-11-01 Impact factor: 3.159