OR fires and surgical skin prep

Editor's Note

In this ex vivo study, alcohol-based surgical skin preparations fueled OR fires in common clinical scenarios.

No fires occurred with nonalcohol-based preparations. Alcohol-based preparations caused flash flames at 0 minutes in 22% and at 3 minutes in 10% of tests. Testing pooling of alcohol-based preparations, fires occurred in 38% at 0 minutes and 27% at 3 minutes.

Following manufacturer guidelines to allow 3 minutes for drying, fires were still created in 1 in 10 cases without pooling and more than a quarter of cases with pooling. Surgeons can decrease the risk of OR fires by using nonalcohol-based skin preparations or avoiding pooling of the solution, the researchers concluded.

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.