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Recognizing hospital-acquired burn injury in patients after coronary artery bypass surgery
1Ralph H. Johnson VA Medical Center, Charleston, South Carolina 29401, USA. Gwammyliz@heavi.tv
Insights
Intraoperative burns, often mistaken for pressure ulcers, can occur when isopropyl alcohol pools under patients on heating pads. This highlights the need to consider burns in atypical postoperative skin injuries.
Area of Science:
- Medical Safety
- Surgical Complications
- Dermatology
Background:
- Nosocomial injuries pose a significant risk in healthcare settings.
- Hospital-acquired pressure ulcers are recognized, but intraoperative burns are underreported.
- Limited data exists on iatrogenic burns during surgical procedures.
Purpose of the Study:
- To identify and characterize intraoperative burn injuries.
- To differentiate these burns from hospital-acquired pressure ulcers.
- To raise awareness of this specific iatrogenic complication.
Main Methods:
- Case series of four patients undergoing coronary artery bypass grafting.
- Clinical examination and investigation of perineal lesions.
- Etiological analysis of injury development.
Main Results:
- Four patients developed perineal lesions post-coronary artery bypass grafting.
- Injuries initially misdiagnosed as pressure ulcers.
- Confirmed as intraoperative burns from isopropyl alcohol and heating pads.
Conclusions:
- Distinguishing intraoperative burns from pressure ulcers can be challenging.
- Intraoperative burns should be considered in the differential diagnosis of atypical postoperative cutaneous injuries.
- Implementation of new diagnostic considerations for postoperative patients is recommended.
Background:
Nosocomial injury is a constant threat in the hospital setting. While there is growing awareness surrounding hospital-acquired pressure ulcers, little information is available on burns associated with intraoperative procedures.
Cases:
We identified perineal lesions on 4 patients who underwent coronary artery bypass with grafting. These injuries were initially classified as pressure ulcers but subsequent investigation revealed that the injuries were intraoperative burns attributable to pooling of isopropyl alcohol underneath patients who were placed on intraoperative heating pads.
Conclusions:
Differentiating between hospital-acquired pressure ulcers and burns can be difficult. Our facility's experience with intraoperative burn injuries now mandates that this etiologic factor be considered in the differential diagnosis of postoperative patients with atypical cutaneous injuries.
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