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Updated: May 26, 2025

Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management
Published on: November 21, 2017
[Strategies for Preventing Fires and Thermal Injuries in the Operating Room]
Maximilian C Stumpfe1, Raymund E Horch1
1Universitätsklinikum Erlangen, Plastische- und Handchirurgische Klinik, Erlangen, Germany.
Abstract:
Thermal injuries and operating room fires pose significant risks to patients, especially when energy-based devices like monopolar diathermy are used. A study conducted by the FDA over 20 years reported over 3,500 injuries and 178 deaths, mostly caused by burns. The main causes of operating room fires can be explained by the "fire triangle": ignition sources, fuels, and oxidizers. Monopolar diathermy and lasers act as ignition sources, while alcohol-based disinfectants provide fuel. As oxidizers, oxygen and nitrous oxide further increase the risk of fire.This review is based on a literature analysis and case vignettes of patients with thermal injuries. It aims to highlight the severe consequences of such injuries and outline preventive measures.The findings underscore the need for a multidisciplinary approach. Key strategies include reducing oxygen concentration and using alternative disinfectants. Targeted training for the surgical team, along with the use of "Fire Risk Assessment Tools", can substantially improve patient safety.In conclusion, comprehensive risk management, the development of specific protocols, and team training are essential to prevent thermal injuries and sustainably reduce patient risk in the operating room.
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