Electrosurgical Devices and Lasers Cited Among Common Causes of Operating Room Fires

A new study has found that the use of lasers and electrosurgical devices in the operating room (OR) are the most likely reason for fires during procedures.

Researchers at the University of Miami (FL, USA) and SRI Surgical (Tampa, FL, USA) designed a questionnaire to elicit the characteristics of OR fires, as experienced by otolaryngologists. The survey was emailed to 8,523 members of the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF). Of these, 349 questionnaires were completed, and 88 surgeons (25.2%) reported that they had experienced at least one operating room fire in their career, 10 experienced two fires each, and two surgeons reported five fires each. Of the 106 reported fires, details were available for 95. The most common ignition sources were an electrosurgical unit (59%), laser (31%), and light cord (6%). Regarding procedures, 27% of fires occurred during endoscopic airway surgery, 25% during oropharyngeal surgery, 22% during cutaneous or transcutaneous surgery, 18% during tracheostomy, 5% related to a light cord, and 1% each were related to an anesthesia machine or endoscopic sinus surgery camera. Significantly, 81% of fires occurred while supplemental oxygen was in use.

Among the common fuels involved in the fires were endotracheal tubes (24%), operating room drapes/towels (20%), and flash fire (i.e., nothing burned) (13%). Less common fuels included preparation solution, gauze sponge, patient's hair or skin, electrosurgical unit with retrofitted insulation over the tip, tracheostomy tube, tonsil sponge, suction tubing, patient's mucosa, electrosurgical unit, light cord, cotton pledgets, jet ventilator catheter, red rubber catheter, and an anesthesia machine. The study was presented at the 2009 American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) annual meeting, held during October 2009 in San Diego (CA, USA).

"In order to minimize the risk of fire, surgeons, particularly otolaryngologists (because of the nature of the surgical procedures they perform), must familiarize themselves with the common scenarios in which fires might occur,” concluded co-author and study presenter Lee Smith, M.D., of SRI Surgical.

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University of Miami
SRI Surgical