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Area of Science:

  • Surgical Safety
  • Biomaterials Science
  • Fire Safety Engineering

Background:

  • Operative fires pose significant risks, with an estimated 650 occurring annually in the US.
  • Electrocautery devices and polymethylmethacrylate (PMMA) are primary ignition and fuel sources in operating room fires.
  • Limited formal studies exist on PMMA flammability when exposed to electrocautery.

Purpose of the Study:

  • To investigate the flammability of polymethylmethacrylate (PMMA) when subjected to electrocautery.
  • To determine the reaction of PMMA to electrocautery ignition in a controlled laboratory setting.
  • To assess the impact of antibiotic additives on PMMA flammability.

Main Methods:

  • A cadaveric leg model was used to simulate PMMA application during total knee arthroplasty (TKA).
  • Two brands of PMMA, with and without antibiotics, were tested for flammability using electrocautery.
  • Flammability was assessed by visual sparks/flames, heat via thermal imaging, and video recording over 15-minute intervals.

Main Results:

  • Polymethylmethacrylate (PMMA), with and without antibiotics, demonstrated flammability when exposed to electrocautery.
  • All ignition events occurred within 7 minutes of PMMA monomer and powder mixing.
  • Antibiotic additives were associated with increased PMMA flammability.

Conclusions:

  • PMMA is highly flammable during its initial curing period when exposed to electrocautery.
  • An "electrocautery timeout" of at least 7 minutes is recommended until PMMA is fully hardened.
  • This measure aims to mitigate the risk of operating room fires caused by PMMA and electrocautery.