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Operating Light Burn in an Orthopaedic Surgery: A Case Report. Indian J Orthop 2021; 56:510-513. [PMID: 35251516 PMCID: PMC8854489 DOI: 10.1007/s43465-021-00497-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 08/20/2021] [Indexed: 02/04/2023]
Abstract
A 40-year-old man with old neglected, non-union, pelvic ring injury right side was surgically treated with open reduction and internal fixation. In the immediate postoperative day, the patient had a large blister adjacent to the surgical site at the right inguinal region which complicated with eschar formation, and later split skin grafting was done. Accidental burns in operation theatre are very unusual. Burns due to electro-cautery and use of alcohol-based antiseptics are well documented in the literature. Iatrogenic burns due to prolonged operating light exposure are very rare and can cause severe damage in sensitive areas like the inguinal region.
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Gualniera P, Scurria S, Sapienza D, Asmundo A. Electrosurgical unit: Iatrogenic injuries and medico-legal aspect. Italian legal rules, experience and article review. Ann Med Surg (Lond) 2021; 62:26-30. [PMID: 33489112 PMCID: PMC7808912 DOI: 10.1016/j.amsu.2020.12.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/19/2020] [Accepted: 12/20/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The use of the electrosurgical unit (ESU) is well-established in the surgical practice. The Authors, to better understand the genesis of injuries connected to the use of electrosurgical instruments, conducted an in-depth literature review pertaining to this topic. MATERIALS AND METHOD Using the most important medical databases, a research of experimental studies in the last 20 years was conducted. RESULTS The analysis of the mechanisms responsible for the lesions showed that high energy devices remain as the most common cause of injury. Adverse events are mainly given by thermal injuries; cases of electromagnetic interference are also described in patients with pacemakers or sacral nerve stimulator and spinal stimulators as well as cases of fire of the endotracheal tube in the course of tracheostomy for the use of the electrosurgical unit in an environment with a high concentration of oxygen or anesthetic gases. Also reported in the literature are individual cases of fires caused by sparks from the electrosurgical handpiece also for the use of disinfectants and/or in relation to surgical drapes. CONCLUSION In order to clearly define the medical-legal aspects, focusing on the professional responsibility of the surgical and nursing staff, the authors' attention was brought to the need for an effective prevention plan that highlights not only the importance of an accurate procedural knowledge in order to safety use the electrosurgical instruments, but also the need for a system that monitors any complications or adverse events resulting from the use of such instruments.
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Affiliation(s)
- Patrizia Gualniera
- Departmental Section of Legal Medicine, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, A.O.U. “G. Martino” Via Consolare Valeria n. 1, 98124, Messina, Italy
| | - Serena Scurria
- Departmental Section of Legal Medicine, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, A.O.U. “G. Martino” Via Consolare Valeria n. 1, 98124, Messina, Italy
| | - Daniela Sapienza
- Departmental Section of Legal Medicine, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, A.O.U. “G. Martino” Via Consolare Valeria n. 1, 98124, Messina, Italy
| | - Alessio Asmundo
- Departmental Section of Legal Medicine, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, A.O.U. “G. Martino” Via Consolare Valeria n. 1, 98124, Messina, Italy
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Jalali SM, Moradi M, Khalaj A, Pazouki A, Tamannaie Z, Ghanbari S. Assessment of Electrosurgery Burns in Cardiac Surgery. Trauma Mon 2015; 20:e18996. [PMID: 26839854 PMCID: PMC4727462 DOI: 10.5812/traumamon.18996] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Revised: 12/05/2014] [Accepted: 01/18/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Monopolar surgery is applied mostly in major operations, while bipolar is used in delicate ones. Attention must be paid in electrosurgery application to avoid electrical burns. OBJECTIVES We aimed to assess factors associated with electrosurgery burns in cardiac surgery operating rooms. PATIENTS AND METHODS This was a case-control study in which two groups of 150 patients undergoing cardiac surgery in Imam Khomeini Hospital were recruited. Several factors like gender, age, operation duration, smoking, diseases, infection, atopia, , immunosuppressive drugs use, hepatic cirrhosis, and pulmonary diseases were compared between the two groups. Patients were observed for 24 hours for development of any burn related to the operation. Data was analyzed using SPSS v.11.5, by Chi square and T-test. RESULTS Patients in the two groups were similar except for two factors. DM and pulmonary diseases which showed significant differences (P = 0.005 and P = 0.002 respectively). Seventy-five patients from controls and 35 from the study group developed burns, which was significant (P ˂ 0.0001). CONCLUSIONS None of the factors were significantly related to developing burns. The differences between the two groups highlights the importance of systems modifications to lessen the incidence of burns.
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Affiliation(s)
- Seyyed Mehdi Jalali
- Minimally Invasive Surgery Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Mohammad Moradi
- Students Research Center, Medical Faculty, Shahed University, Tehran, IR Iran
| | - Alireza Khalaj
- Minimally Invasive Surgery Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
- Mostafa Khomeini Hospital, Medical Faculty, Shahed University, Tehran, IR Iran
- Corresponding author: Alireza Khalaj, Minimally Invasive Surgery Research Center, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-9121307425, Fax: +98-2166505690, E-mail:
| | - Alireza Pazouki
- Minimally Invasive Surgery Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Zeinab Tamannaie
- Minimally Invasive Surgery Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Sajjad Ghanbari
- Minimally Invasive Surgery Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
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Patterson T, Stecker MM, Netherton BL. Mechanisms of Electrode Induced Injury. Part 2: Clinical Experience. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/1086508x.2007.11079617] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Terry Patterson
- Department of Neurosurgery Penn State Medical Center Hershey, Pennsylvania
| | - Mark M. Stecker
- Department of Neurology Geisinger Medical Center Danville, Pennsylvania
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Lesiones cutáneas agudas tras intervenciones quirúrgicas. Aproximación clínica. ACTAS DERMO-SIFILIOGRAFICAS 2013; 104:776-81. [DOI: 10.1016/j.ad.2013.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Revised: 03/04/2013] [Accepted: 04/07/2013] [Indexed: 11/18/2022] Open
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Borrego L. Acute Skin Lesions After Surgical Procedures: A Clinical Approach. ACTAS DERMO-SIFILIOGRAFICAS 2013. [DOI: 10.1016/j.adengl.2013.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Cassier S, Duhamel P, Duhoux A, Brachett M, Lakhel A, Bey E. Prévention des infections nosocomiales et brûlures iatrogènes : rappel des règles et précautions à respecter au bloc opératoire. ANN CHIR PLAST ESTH 2011; 56:558-61. [DOI: 10.1016/j.anplas.2010.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Accepted: 10/11/2010] [Indexed: 10/18/2022]
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Recognizing hospital-acquired burn injury in patients after coronary artery bypass surgery. J Wound Ostomy Continence Nurs 2011; 38:193-5. [PMID: 21389831 DOI: 10.1097/won.0b013e31820bc479] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
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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Afonso CT, Silva ALD, Fabrini DS, Afonso CT, Côrtes MGW, Sant'Anna LL. Risco do uso do eletrocautério em pacientes portadores de adornos metálicos. ABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA 2010. [DOI: 10.1590/s0102-67202010000300010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
INTRODUÇÃO: A eletrocirurgia é tecnologia conhecida há longo tempo que, atualmente, tem adquirido cada vez mais destaque. Apesar disso, ainda apresenta vários riscos quanto à sua utilização. Várias lesões podem ser causadas por eletrocautérios, sendo as queimaduras a complicação mais frequente. Nem sempre existe a cooperção do paciente frente a medidas preventivas. MÉTODO: Revisão da literatura pertinente em função de questionamento jurídico de paciente que se negou a retirar seus ornamentos no início de procedimento cirúrgico, já estando ela na sala de operações. CONCLUSÃO: É essencial o conhecimento dos fundamentos da eletrocirurgia, seu uso correto, equipamento seguro, monitoramento constante e investigação imediata diante de quaisquer suspeitas, para minimizar o risco de acidentes em paciente com adornos metálicos, e a cooperação do paciente na obediência das medidas preventivas de acidentes deve ser obrigatória.
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de Armendi AJ, Shukry M, Strong P, Cure JA. Headlight with fiber-optic xenon light source may cause harm to patients. Am J Otolaryngol 2010; 31:57-8. [PMID: 19944902 DOI: 10.1016/j.amjoto.2008.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2008] [Revised: 08/05/2008] [Accepted: 08/17/2008] [Indexed: 11/26/2022]
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Congenital cardiac surgical complications of the integument, vascular system, vascular-line(s), and wounds: consensus definitions from the Multi-Societal Database Committee for Pediatric and Congenital Heart Disease. Cardiol Young 2008; 18 Suppl 2:245-55. [PMID: 19063799 DOI: 10.1017/s1047951108003016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A complication is an event or occurrence that is associated with a disease or a healthcare intervention, is a departure from the desired course of events, and may cause, or be associated with, suboptimal outcome. A complication does not necessarily represent a breech in the standard of care that constitutes medical negligence or medical malpractice. An operative or procedural complication is any complication, regardless of cause, occurring (1) within 30 days after surgery or intervention in or out of the hospital, or (2) after 30 days during the same hospitalization subsequent to the operation or intervention. Operative and procedural complications include both intraoperative/intraprocedural complications and postoperative/postprocedural complications in this time interval. The MultiSocietal Database Committee for Pediatric and Congenital Heart Disease has set forth a comprehensive list of complications associated with the treatment of patients with congenital cardiac disease, related to cardiac, pulmonary, renal, haematological, infectious, neurological, gastrointestinal, and endocrinal systems, as well as those related to the management of anaesthesia and perfusion, and the transplantation of thoracic organs. The objective of this manuscript is to examine the definitions of operative morbidity as they relate specifically to a collection of loosely related topics that include the following groups of complications: 1) Complications of the Integument, 2) Complications of the Vascular System, 3) Complications of the Vascular-Line(s), 4) Complications of Wounds. These specific definitions and terms will be used to track morbidity associated with surgical and transcatheter interventions and other forms of therapy in a common language across many separate databases. As surgical survival in children with congenital cardiac disease has improved in recent years, focus has necessarily shifted to reducing the morbidity of congenital cardiac malformations and their treatment. A comprehensive list of complications is presented. This list is a component of a systems-based compendium of complications that will standardize terminology and thereby allow the study and quantification of morbidity in patients with congenital cardiac malformations. Clinicians caring for patients with congenital cardiac disease will be able to use this list for databases, initiatives to improve quality, reporting of complications, and comparing strategies of treatment.
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Abstract
The purpose of this report is to increase awareness of intraoperative burns during standard procedures, to discuss their possible causes and warning signs and to provide recommendations for prevention and procedures to follow after their occurrence. A total of 19 patients associated with intraoperative burn accidents were treated surgically and analyzed after a mean follow-up of 5 +/- 3.5 months. Review included retrospective patient chart analysis, clinical examination, and technical device and equipment testing. A total of 15 patients recently underwent cardiac surgery, and 4 pediatric patients recovered after standard surgical procedures. A total of 15 patients had superficial and 4 presented with deep dermal or full-thickness burns. The average injured TBSA was 2.1 +/- 1% (range, 0.5-4%). Delay between primary surgery and consultation of plastic surgeons was 4.5 +/- 3.4 days. A total of 44% required surgery, including débridment, skin grafting or musculocutaneous gluteus maximus flaps, and the remaining patients were treated conservatively. Successful durable soft-tissue coverage of the burn region was achieved in 18 patients, and 1 patient died after a course of pneumonia. Technical analysis demonstrated one malfunctioning electrosurgical device, one incorrect positioned neutral electrode, three incidents occurred after moisture under the negative electrode, eight burns occurred during surgery while fluid or blood created alternate current pathways, five accidents were chemical burns after skin preparation with Betadine solution, and in one case, the cause was not clear. The surgical team should pay more attention to the probability of burns during surgery. Early patient examination and immediate involvement of plastic and burn surgeons may prevent further complications or ease handling after the occurrence.
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Affiliation(s)
- Erhan Demir
- Department of Plastic and Hand Surgery, Burn Center, University Hospital RWTH Aachen, Aachen, Germany
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