Operating room fire: Should we mistrust alcoholic antiseptics?

Surgical site infections are a challenge for public health. One of the keystones of prevention is the skin preparation of the patient. Alcoholic antiseptics are presented as the best solution. But the adverse effects attributed to them must not be overshadowed by the exclusive benefit of their microbiological performance. The authors report four cases of severe burn having occurred in the operating room after skin antisepsis performed with an alcoholic antiseptic. The mechanisms of these accidents and preventive measures are reviewed. It concerns the restriction of ignition factors during use and the strict conformity to drying time. These potentially dramatic complications can and should be avoided. Probably underestimated, burns due to ignition of alcoholic antiseptics should appear more clearly in the evaluation of the risk-benefit balance.