Incidence of Operating Room Fires During Hand Surgical Procedures

Document Type : RESEARCH PAPER

Authors

1 Rothman Orthopedics, Hand & Upper Extremity Surgery 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107, USA

2 Department of Orthopedic Surgery, Thomas Jefferson University, Sidney Kimmel Medical Center, Philadelphia, PA, USA

Abstract

Background: The purpose of the present study is to report the incidence of operating room fires during hand surgical procedures. Methods: The clinic and OR electronic medical records of seven fellowship-trained orthopedic hand surgeons at a single, large practice were retrospectively reviewed. All upper extremity procedures performed between June 2014 to June 2019 in both hospital and surgery center settings were included in the review. Demographic data was collected. The incidence of operating room fires was determined. Results: A total of 18,819 hand and upper extremity surgical procedures were included. There were 16,767 (89.1%) cases performed in a surgery center, while 2,052 (10.9%) of cases were performed in a hospital. There were 12,691 (67.4%) soft tissue procedures and 6,127 (32.6%) bony procedures performed. Chlorhexidine gluconate preparation solution was used in 9607 cases (51%). Chloraprep solution was used in 6280 cases (33.4%). Betadine was used in 2,932 cases (15.6%). One surgeon has monopolar electrocautery only available during cases. Five surgeons have bipolar available, and one has both mono and bipolar electrocautery available. There were no fires (0%) identified during the study period. Conclusion: The incidence of operating room fires during hand surgical procedures is extremely low. While hand surgeons can be reassured that the likelihood of an operating room fire is minimal, surgeons should not become complacent and should maintain a high level of vigilance to prevent these potentially devastating occurences. Level of evidence: IV

Keywords

References

1. Jones TS, Black IH, Robinson TN, Jones EL. Operating Room Fires. Anesthesiology. 2019;130(3):492-501.
2. Mehta SP, Bhananker SM, Posner KL, Domino KB. Operating room fires: a closed claims analysis. Anesthesiology. 2013;118(5):1133-1139.
3. Jones EL, Overbey DM, Chapman BC, Jones TS, Hilton SA, Moore JT , et al. Operating Room Fires and Surgical Skin Preparation. J Am Coll Surg. 2017;225(1):160-165.
4.https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=adf7e698-bfbb-49b8-961e-dde1b2d34fb6&type=display. Access date: 12-5-21
5. Quality Forum. https://www.qualityforum.org/Publications/2017/04/Surgery_2015-2017_Final_Report.aspx. Access date: 9-19-19
6. Clarke JR BM. Surgical Fires: Trends Associated with Prevention Efforts. Pa Patient Saf Advis. 2012;9(4):130-135.
7. Mathias J. Scoring fire risk for surgical patients. . OR Manager. 2006;22:19-20.
8. Dennison DA. Scoring patients for fire risk adds to safety. Nursing. 2011;41(2):67-68.
9. Culp WC, Jr., Kimbrough BA, Luna S. Flammability of surgical drapes and materials in varying concentrations of oxygen. Anesthesiology. 2013;119(4):770-776.
10. Xu PZ, Fowler JR, Goitz RJ. Prospective Randomized Trial Comparing the Efficacy of Surgical Preparation Solutions in Hand Surgery. Hand (N Y). 2017;12(3):258-264.
11. Asadpoor-Dezaki Z BA, Abtahi D. Comparison of Two Surgical Hand Antiseptic Techniques: Hand Rubbing and Hand Washing With Alcohol-Based Agent and 7.5% Povidone Iodine. Journal of Critical Care Nursing 2016;9(4):8255.
12. Seigerman DA, Rivlin M, Bianchini J, Liss FE, Beredjiklian PK. A Comparison of Two Sterile Solution Application Methods During Surgical Preparation of the Hand. J Hand Surg Am. 2016;41(6):698-702.
13. Chang BW, Petty P, Manson PN. Patient fire safety in the operating room. Plast Reconstr Surg. 1994;93(3):519-521.
14. Rocos B, Donaldson LJ. Alcohol skin preparation causes surgical fires. Ann R Coll Surg Engl. 2012;94(2):87-89.
15. Patel R, Chavda KD, Hukkeri S. Surgical field fire and skin burns caused by alcohol-based skin preparation. J Emerg Trauma Shock. 2010;3(3):305.
16. Tooher R, Maddern GJ, Simpson J. Surgical fires and alcohol-based skin preparations. ANZ J Surg. 2004;74(5):382-385.
17. Berrios-Torres SI, Umscheid CA, Bratzler DW, Leas B, Stone EC, Kelz RR, et al. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surg. 2017;152(8):784-791.
18. Saltzman MD, Nuber GW, Gryzlo SM, Marecek GS, Koh JL. Efficacy of surgical preparation solutions in shoulder surgery. J Bone Joint Surg Am. 2009;91(8):1949-1953. 
The Archives of Bone and Joint Surgery
Volume 10, Issue 1
January 2022
Pages 56-59

Files

History

  • Receive Date: 21 April 2020
  • Revise Date: 28 February 2021
  • Accept Date: 09 March 2021

Share

How to cite

Statistics