Surgical Fires and Operative Burns: Lessons Learned From a 33-Year Review of Medical Litigation

Choudhry, Asad J.; Haddad, Nadeem N.; Khasawneh, Mohammad A.; Cullinane, Daniel C.; Zielinski, Martin D.

doi:10.1016/j.amjsurg.2016.12.006

Cited by 34 publications

(19 citation statements)

References 6 publications

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“…Although intraoperative fires are considered surgical “never” events, they occurred in 11% of events (73 events). However, they rarely resulted in patient hospitalization (6 events, 3%) …”

Section: Discussionmentioning

confidence: 99%

Rare electrosurgical complications in tonsillectomy: Analysis of national adverse event reporting

Yamasaki

Bhattacharyya

2019

The Laryngoscope

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Objectives: To identify U.S. Food and Drug Administration (FDA)-reported adverse events related to electrosurgical devices during tonsillectomy and characterize the most common devices and patient/provider sequelae.Study Design: Retrospective analysis of FDA database of device-related adverse events. Methods: Data were extracted from the OpenFDA database for all adverse events reported for electrosurgical devices used in tonsillectomies from January 2008 to December 2017. Adverse events were classified by device, event type, etiology, complication severity, and patient disposition.Results: Six hundred fifty-two adverse events were identified, with 195 events (30%) leading to known bodily injury to patient/provider. Device failure was the most common adverse event (202 events, 31%), followed by burns in 187 patient (98% of burns) and three provider events (2%). Burn injuries occurred most frequently with coblation devices (78 events, 42% of burns), monopolar electrocautery (48 events, 25%), and electrosurgical generators (23 events, 13%). Burn injuries most commonly occurred in the oral cavity (144 events, 76% of burn events) and were most commonly first-degree (28 events, 15%). Complications related to burns were managed conservatively for 36% of burn events (68 events), and secondary surgery was rarely required (8 events, 4%). Postoperative bleeding (173 events, 26%; 3 deaths) and intraoperative fire (73 events, 11%) were also reported. Device failures caused significant OR delay or cancellation in 17% of occurrences (35 events).Conclusion: Numerous complications may occur with various devices used during tonsillectomy and can result in significant patient/provider harm and sequelae. Surgeons must understand the nature of such complications to facilitate safe perioperative care and inform preoperative patient discussions.

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Section: Discussionmentioning

confidence: 99%

Rare electrosurgical complications in tonsillectomy: Analysis of national adverse event reporting

Yamasaki

Bhattacharyya

2019

The Laryngoscope

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“…[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.…”

Section: Introductionmentioning

confidence: 99%

Prevention of surgical fires in facial plastic surgery

Alani

Southwell‐Keely

Moisidis

et al. 2019

Australas J Plast Surg

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Introduction: The objective of this review is to draw attention to the risk factors, causes and prevention of surgical fires in facial plastic and reconstructive surgery performed under local anaesthesia and sedation using a review of the literature.Method: Comprehensive search terms were developed, and PubMed and MEDLINE® searches were performed, including articles published in the last 25 years (1993–2018). Reference review was also undertaken. Eligible manuscripts described surgical fires involving patients undergoing surgical procedures under local anaesthesia in the head and neck region.Results: Risk factors forming the three arms of the fire triangle are detailed. High oxygen concentration in proximity to the surgical field where electrocautery is being used is the most common combination leading to surgical fire accidents. Conclusion: Summary recommendations for the prevention of surgical fires are presented. Preventing the development of an oxidiser-enriched environment is the main risk-reducing measure. Identifying high-risk cases and improving communication between the surgical, anaesthetic and nursing staff who control the arms of the fire triangle are very important measures in avoiding theses catastrophic events.

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“…A search of the anaesthetic and surgical literature, especially from the United States (US), indicates that there has been a noticeable increase in interest in educating perioperative staff on how to prevent surgical fires. This is vital, as surgical fires can have devastating outcomes for patients, such as fatal or disfiguring injuries leading to an extended hospital stay, and they can be psychologically traumatic for patients and the staff involved (Bruley 2017, Choudhry et al 2017, Watson 2010). The most common sites for surgical fires to occur are in the airway, face, neck and upper chest (Bruley 2017, Daane & Toth 2005, Hart et al 2011, Smith & Roy 2011, Yardley & Donaldson 2010).…”

Section: Introductionmentioning

confidence: 99%

Surgical fires: Still a burning issue in England and Wales

Cooper

2019

Journal of Perioperative Practice

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A significant number of surgical fires occur each year and can have devastating effects on patients. The National Reporting and Learning System database identified 37 reports of surgical fires in England and Wales between January 2012 and December 2018 – over 52% resulting in some degree of harm. Surgical fires remain preventable adverse events that can be avoided by adherence to effective preventative strategies and improved education. This article surveys the existing literature, addressing the fire triad and how to effectively manage and prevent a surgical fire.

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Surgical Fires and Operative Burns: Lessons Learned From a 33-Year Review of Medical Litigation

Cited by 34 publications

References 6 publications

Rare electrosurgical complications in tonsillectomy: Analysis of national adverse event reporting

Rare electrosurgical complications in tonsillectomy: Analysis of national adverse event reporting

Prevention of surgical fires in facial plastic surgery

Surgical fires: Still a burning issue in England and Wales

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