Operating room fires in periocular surgery

Abstract

An intraoperative fire can be costly for both the patient and the surgeon. Ophthalmic surgeons operate in an oxygen rich and therefore flammable environment. Proactive measures can be undertaken to reduce the incidence of surgical fires periocular surgery; however, a fire can occur at any time and the entire operating room team must be constantly vigilant to prevent and manage operating room fires.

Prevention of surgical fires in facial plastic surgery

“…an oxidiser, an ignition source and fuel, 2,[8][9][10]14,15 ( Figure 1). Together these are known as the 'fire triangle' or 'fire triad'.…”

“…6 Oxygen-enriched environments occur far more frequently around patients receiving supplemental high-flow oxygen (>3-4 L/ min) compared with those receiving supplemental oxygen at low flow rates (2 L/min). 2,7,8,16,17 The proximity of the oxidiser to the ignition source plays an important role, Draping can create occlusive tenting and trap oxygen, raising its concentration, and many studies suggested open-drape techniques to avoid oxygen pooling. 1,9,17,18 Nitrous oxide also acts as an oxidiser and both increase the likelihood and intensity of combustion in the surgical field in a concentration-related manner.…”

“…Pulse lavage power cord Rapp C, Gaines R, 2012 22 Case report Table 1. Different ignition/heat sources that resulted in fire accidents in the literature Alani, Southwell-Keely, Moisidis et al: Prevention of surgical fires in facial plastic surgery is in close proximity to the oxygen source 7,8,12,21 and at a setting higher than 15 Watts (W). 7,20 Laser is the second most common cause of operating theatre fire ignition.…”

“…[1][2][3] The vast majority of surgical fires occur during surgery of the head and neck region, including otolaryngology, maxillofacial surgery and neurosurgery. 2,[4][5][6][7][8][9][10] The face is the second most common surgical site injured by surgical fire accidents, with only fire during tonsillectomy being more common. 11 A survey of personal experiences of surgical fires by members of the American Society of Ophthalmic Plastic and Reconstructive Surgery reported that 43.5 per cent of surgeons have had at least one operating room fire.…”

“…11 A survey of personal experiences of surgical fires by members of the American Society of Ophthalmic Plastic and Reconstructive Surgery reported that 43.5 per cent of surgeons have had at least one operating room fire. 8 In the USA, the prevalence of surgical fires has been estimated at approximately 600 events per year. 12,13 A recent event in our institution was the stimulus…”