Surgical antisepsis and the risk of operating theatre fires

Maiwald, Matthias; Farmer, Chris J. M.; Lance, David; Nieuwenhuijs, Vincent B.; Heath, Christopher H.; Watson, David I.; Gordon, David L.

doi:10.1111/j.1445-2197.2006.03736.x

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…However, other investigators demonstrated that alcohol‐based skin preparation agents are more effective at preventing surgical site infections as compared with their aqueous‐based counterparts 48 . Furthermore, alcohol‐based skin preparation agents have rarely been implicated in surgical fires when used according to manufacturer instructions 49 . Hence, proponents encourage continued use of these agents, emphasizing the importance of allowing sufficient agent drying time and arguing the benefits outweigh the risks 49 .…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, alcohol‐based skin preparation agents have rarely been implicated in surgical fires when used according to manufacturer instructions 49 . Hence, proponents encourage continued use of these agents, emphasizing the importance of allowing sufficient agent drying time and arguing the benefits outweigh the risks 49 . According to this review, 2 otolaryngologic surgical fires occurred after application of DuraPrep (74% isopropyl alcohol) and Prevail (59% ethanol) in an unshaved, hirsute patient undergoing tracheostomy and in the unclipped scalp of a patient undergoing a retroauricular mass excision, respectively; in both cases, at least 3 minutes of drying time was observed 50,51 .…”

Section: Discussionmentioning

confidence: 99%

“…49 Hence, proponents encourage continued use of these agents, emphasizing the importance of allowing sufficient agent drying time and arguing the benefits outweigh the risks. 49 According to this review, 2 otolaryngologic surgical fires occurred after application of DuraPrep (74% isopropyl alcohol) and Prevail (59% ethanol) in an unshaved, hirsute patient undergoing tracheostomy and in the unclipped scalp of a patient undergoing a retroauricular mass excision, respectively; in both cases, at least 3 minutes of drying time was observed. 50,51 Although otolaryngologic surgical fires attributed to alcohol-based skin preparation agents are rare, clinicians may consider avoiding the use of such agents in unshaved, dense hair-bearing areas.…”

Section: Preventionmentioning

confidence: 99%

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Surgical Fires in Otolaryngology: A Systematic and Narrative Review

Day

Rivera

Farlow

et al. 2018

Otolaryngol.--head neck surg.

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Objective To bring attention to the epidemiology, prevention, management, and consequences of surgical fires in otolaryngology by reviewing the literature. Data Sources PubMed, EMBASE, Web of Science, and Scopus. Review Methods Comprehensive search terms were developed, and searches were performed from data source inception through August 2016. A total of 4506 articles were identified; 2351 duplicates were removed; and 2155 titles and abstracts were independently reviewed. Reference review was also performed. Eligible manuscripts described surgical fires involving patients undergoing otolaryngologic procedures. Results Seventy-two articles describing 87 otolaryngologic surgical fire cases were identified. These occurred during oral cavity or oropharyngeal procedures (11%), endoscopic laryngotracheal procedures (25%), tracheostomies (36%), "other" general anesthesia procedures (3%), and monitored anesthesia care or local procedures (24%). Oxidizing agents consisted of oxygen alone (n = 63 of 81, 78%), oxygen and nitric oxide (n = 17 of 81, 21%), and room air (n = 1 of 81, 1%). The fractional inspired oxygen delivered was >30% in 97% of surgical fires in non-nitrous oxide general anesthesia cases (n = 35 of 36). Laser-safe tubes were used in only 12% of endoscopic laryngotracheal cases with endotracheal tube descriptions (n = 2 of 17). Eighty-six percent of patients experienced acute complications (n = 76 of 87), including 1 intraoperative death, and 22% of patients (n = 17 of 77) experienced long-term complications. Conclusion Surgical fires in otolaryngology persist despite aggressive multi-institutional efforts to curb their incidence. Guideline recommendations to minimize the concentration of delivered oxygen and use laser-safe tubes when indicated were not observed in many cases. Improved institutional fire safety practices are needed nationally and internationally.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Preventionmentioning

confidence: 99%

See 1 more Smart Citation

Surgical Fires in Otolaryngology: A Systematic and Narrative Review

Day

Rivera

Farlow

et al. 2018

Otolaryngol.--head neck surg.

View full text Add to dashboard Cite

show abstract

“…[15][16][17] In addition, alcohol based antiseptic solution spilt onto the bed and floor poses a further fire risk. This is more likely during the painting technique compared to the bag immersion technique when there was only minor spillage of antiseptic solution from preparation to bag removal.…”

Section: Discussionmentioning

confidence: 99%