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Operating room fires in periocular surgery.

Michael A Connor1, Anne M Menke2, Ivan Vrcek3

  • 1Oculoplastic and Orbital Consultants, West Palm Beach, FL, USA.

International Ophthalmology
|May 22, 2017
PubMed
Summary

Operating room fires during periocular surgery can lead to costly lawsuits and patient burns. Vigilance and proactive prevention strategies are crucial for ophthalmic surgeons in oxygen-rich environments.

Keywords:
FireFiresOR firesOperating room fires

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Area of Science:

  • Ophthalmology
  • Surgical Safety
  • Biomedical Engineering

Background:

  • Periocular surgery presents unique risks due to the proximity of sensitive tissues and the potential for oxygen-enriched atmospheres.
  • Operating room fires, though infrequent, can have devastating consequences for patients and lead to significant legal and financial repercussions for surgeons.

Purpose of the Study:

  • To analyze the incidence, causes, and outcomes of operating room fires in periocular surgery.
  • To assess the experiences of ophthalmic plastic and reconstructive surgeons with surgical fires.
  • To evaluate existing fire prevention policies in surgical settings.

Main Methods:

  • A retrospective review of closed claims data from the Ophthalmic Mutual Insurance Company (OMIC) over seven years.
  • A survey distributed to members of the American Society of Oculoplastic and Reconstructive Surgeons regarding personal experiences with operating room fires.

Main Results:

  • OMIC managed seven lawsuits related to periocular surgical fires over two decades, with a mean settlement of $145,285.
  • Forty-four percent of surveyed surgeons reported experiencing at least one operating room fire, often in the presence of supplemental oxygen.
  • Monopolar cautery and high-temperature cautery were common ignition sources, and 48% of patients experienced complications; 69% of hospital ORs have fire prevention policies.

Conclusions:

  • Intraoperative fires in ophthalmic surgery are a significant risk, leading to substantial costs and patient harm.
  • The use of supplemental oxygen and cautery in oxygen-rich environments increases flammability.
  • Constant vigilance and robust fire prevention protocols involving the entire surgical team are essential to mitigate the risk of periocular surgical fires.