The Dreaded 3-Minute Wait: Does It Really Prevent Operating Room Fires? The IGNITE Trial
Operating room fires can have devastating consequences and as such must be prevented. There exists a paucity of literature requiring further elucidation regarding manufacturer recommendations of a predefined waiting period prior to patient draping after using alcohol-based surgical antiseptics, in o...
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creator | Keenan, Corey Danis, Hillary Fraley, Jim Roets, Jack Spitzer, Holly Grasso, Samuel |
description | Operating room fires can have devastating consequences and as such must be prevented. There exists a paucity of literature requiring further elucidation regarding manufacturer recommendations of a predefined waiting period prior to patient draping after using alcohol-based surgical antiseptics, in order to reduce the risk of operating room fires.
This was further investigated by exposing two common alcohol-based surgical antiseptics to electrosurgery and open flames at various power settings and time intervals in an ex vivo porcine model. The simulated surgical site was prepped following manufacturer recommendations and exposed to monopolar electrosurgery at low and high power, using both PURE CUT and COAGULATION modes, and open flame, at 15-s increments after application.
While using PURE CUT mode at both low and high power, no ignition was observed on hairless surgical sites prepped with ChloraPrep® at any time point. However, use of COAGULATION mode at both low and high powers resulted in ignition consistently out to 1-min post-application. Additionally, if the prepped area subjectively appeared wet, especially with pooling of the antiseptic, both COAGULATION mode and open flame caused ignition. Dry time was found to be about 59 s for both prep solutions. It was also observed that the amount of pressure directly correlated with the amount of prep dispersed and increased dry times.
In conclusion, our data suggest an average dry time of less than 1-min, with ignition only observed when the antiseptic was visibly wet. Ignition did not occur on hairless skin with electrocautery on CUT mode using ChloraPrep at any time point. Additionally, ignition on hair-bearing skin was not observed past 3 min, with current manufacturer recommendations stating 1 h wait time for hair-bearing skin. Arbitrarily waiting a specific predetermined dry time until patient draping, as recommended by the manufacturers, may be unnecessary and lead to hours' worth of time wasted each year. Ongoing research will further investigate the utility of drying the antiseptic after application and its affect on not only preventing ignition but also antimicrobial efficacy. |
doi_str_mv | 10.1093/milmed/usae300 |
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This was further investigated by exposing two common alcohol-based surgical antiseptics to electrosurgery and open flames at various power settings and time intervals in an ex vivo porcine model. The simulated surgical site was prepped following manufacturer recommendations and exposed to monopolar electrosurgery at low and high power, using both PURE CUT and COAGULATION modes, and open flame, at 15-s increments after application.
While using PURE CUT mode at both low and high power, no ignition was observed on hairless surgical sites prepped with ChloraPrep® at any time point. However, use of COAGULATION mode at both low and high powers resulted in ignition consistently out to 1-min post-application. Additionally, if the prepped area subjectively appeared wet, especially with pooling of the antiseptic, both COAGULATION mode and open flame caused ignition. Dry time was found to be about 59 s for both prep solutions. It was also observed that the amount of pressure directly correlated with the amount of prep dispersed and increased dry times.
In conclusion, our data suggest an average dry time of less than 1-min, with ignition only observed when the antiseptic was visibly wet. Ignition did not occur on hairless skin with electrocautery on CUT mode using ChloraPrep at any time point. Additionally, ignition on hair-bearing skin was not observed past 3 min, with current manufacturer recommendations stating 1 h wait time for hair-bearing skin. Arbitrarily waiting a specific predetermined dry time until patient draping, as recommended by the manufacturers, may be unnecessary and lead to hours' worth of time wasted each year. Ongoing research will further investigate the utility of drying the antiseptic after application and its affect on not only preventing ignition but also antimicrobial efficacy.</description><identifier>ISSN: 0026-4075</identifier><identifier>ISSN: 1930-613X</identifier><identifier>EISSN: 1930-613X</identifier><identifier>DOI: 10.1093/milmed/usae300</identifier><identifier>PMID: 38850224</identifier><language>eng</language><publisher>England</publisher><subject>Animals ; Anti-Infective Agents, Local - administration & dosage ; Anti-Infective Agents, Local - therapeutic use ; Electrosurgery - instrumentation ; Electrosurgery - methods ; Electrosurgery - standards ; Fires - prevention & control ; Fires - statistics & numerical data ; Humans ; Operating Rooms - methods ; Operating Rooms - standards ; Swine ; Time Factors</subject><ispartof>Military medicine, 2024-11, Vol.189 (11-12), p.e2468-e2474</ispartof><rights>The Association of Military Surgeons of the United States 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site–for further information please contact journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c180t-e6d7d8b875966f5fb74e09af27423317f547778cc56b38edff132c267371c9cb3</cites><orcidid>0009-0005-6878-087X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38850224$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Keenan, Corey</creatorcontrib><creatorcontrib>Danis, Hillary</creatorcontrib><creatorcontrib>Fraley, Jim</creatorcontrib><creatorcontrib>Roets, Jack</creatorcontrib><creatorcontrib>Spitzer, Holly</creatorcontrib><creatorcontrib>Grasso, Samuel</creatorcontrib><title>The Dreaded 3-Minute Wait: Does It Really Prevent Operating Room Fires? The IGNITE Trial</title><title>Military medicine</title><addtitle>Mil Med</addtitle><description>Operating room fires can have devastating consequences and as such must be prevented. There exists a paucity of literature requiring further elucidation regarding manufacturer recommendations of a predefined waiting period prior to patient draping after using alcohol-based surgical antiseptics, in order to reduce the risk of operating room fires.
This was further investigated by exposing two common alcohol-based surgical antiseptics to electrosurgery and open flames at various power settings and time intervals in an ex vivo porcine model. The simulated surgical site was prepped following manufacturer recommendations and exposed to monopolar electrosurgery at low and high power, using both PURE CUT and COAGULATION modes, and open flame, at 15-s increments after application.
While using PURE CUT mode at both low and high power, no ignition was observed on hairless surgical sites prepped with ChloraPrep® at any time point. However, use of COAGULATION mode at both low and high powers resulted in ignition consistently out to 1-min post-application. Additionally, if the prepped area subjectively appeared wet, especially with pooling of the antiseptic, both COAGULATION mode and open flame caused ignition. Dry time was found to be about 59 s for both prep solutions. It was also observed that the amount of pressure directly correlated with the amount of prep dispersed and increased dry times.
In conclusion, our data suggest an average dry time of less than 1-min, with ignition only observed when the antiseptic was visibly wet. Ignition did not occur on hairless skin with electrocautery on CUT mode using ChloraPrep at any time point. Additionally, ignition on hair-bearing skin was not observed past 3 min, with current manufacturer recommendations stating 1 h wait time for hair-bearing skin. Arbitrarily waiting a specific predetermined dry time until patient draping, as recommended by the manufacturers, may be unnecessary and lead to hours' worth of time wasted each year. Ongoing research will further investigate the utility of drying the antiseptic after application and its affect on not only preventing ignition but also antimicrobial efficacy.</description><subject>Animals</subject><subject>Anti-Infective Agents, Local - administration & dosage</subject><subject>Anti-Infective Agents, Local - therapeutic use</subject><subject>Electrosurgery - instrumentation</subject><subject>Electrosurgery - methods</subject><subject>Electrosurgery - standards</subject><subject>Fires - prevention & control</subject><subject>Fires - statistics & numerical data</subject><subject>Humans</subject><subject>Operating Rooms - methods</subject><subject>Operating Rooms - standards</subject><subject>Swine</subject><subject>Time Factors</subject><issn>0026-4075</issn><issn>1930-613X</issn><issn>1930-613X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1kM1LwzAYh4Mobk6vHiVHL92Spm0SLyL7cjCdjIq7lTR9o5F-zKQV9t_r2HZ64eX5PYcHoVtKhpRINqpsWUEx6rwCRsgZ6lPJSJBQtjlHfULCJIgIj3voyvtvQmgkBb1EPSZETMIw6qNN-gV44kAVUGAWvNi6awF_KNs-4EkDHi9avAZVljv85uAX6havtuBUa-tPvG6aCs-sA_-I957F_HWRTnHqrCqv0YVRpYeb4x2g99k0HT8Hy9V8MX5aBpoK0gaQFLwQueCxTBITm5xHQKQyIY9Cxig3ccQ5F1rHSc4EFMZQFuow4YxTLXXOBuj-4N265qcD32aV9RrKUtXQdD5jJIklF1Lyf3R4QLVrvHdgsq2zlXK7jJJsXzM71MyONf8Hd0d3l-__J_yUj_0BHCNwcg</recordid><startdate>20241105</startdate><enddate>20241105</enddate><creator>Keenan, Corey</creator><creator>Danis, Hillary</creator><creator>Fraley, Jim</creator><creator>Roets, Jack</creator><creator>Spitzer, Holly</creator><creator>Grasso, Samuel</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0009-0005-6878-087X</orcidid></search><sort><creationdate>20241105</creationdate><title>The Dreaded 3-Minute Wait: Does It Really Prevent Operating Room Fires? 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The IGNITE Trial</atitle><jtitle>Military medicine</jtitle><addtitle>Mil Med</addtitle><date>2024-11-05</date><risdate>2024</risdate><volume>189</volume><issue>11-12</issue><spage>e2468</spage><epage>e2474</epage><pages>e2468-e2474</pages><issn>0026-4075</issn><issn>1930-613X</issn><eissn>1930-613X</eissn><abstract>Operating room fires can have devastating consequences and as such must be prevented. There exists a paucity of literature requiring further elucidation regarding manufacturer recommendations of a predefined waiting period prior to patient draping after using alcohol-based surgical antiseptics, in order to reduce the risk of operating room fires.
This was further investigated by exposing two common alcohol-based surgical antiseptics to electrosurgery and open flames at various power settings and time intervals in an ex vivo porcine model. The simulated surgical site was prepped following manufacturer recommendations and exposed to monopolar electrosurgery at low and high power, using both PURE CUT and COAGULATION modes, and open flame, at 15-s increments after application.
While using PURE CUT mode at both low and high power, no ignition was observed on hairless surgical sites prepped with ChloraPrep® at any time point. However, use of COAGULATION mode at both low and high powers resulted in ignition consistently out to 1-min post-application. Additionally, if the prepped area subjectively appeared wet, especially with pooling of the antiseptic, both COAGULATION mode and open flame caused ignition. Dry time was found to be about 59 s for both prep solutions. It was also observed that the amount of pressure directly correlated with the amount of prep dispersed and increased dry times.
In conclusion, our data suggest an average dry time of less than 1-min, with ignition only observed when the antiseptic was visibly wet. Ignition did not occur on hairless skin with electrocautery on CUT mode using ChloraPrep at any time point. Additionally, ignition on hair-bearing skin was not observed past 3 min, with current manufacturer recommendations stating 1 h wait time for hair-bearing skin. Arbitrarily waiting a specific predetermined dry time until patient draping, as recommended by the manufacturers, may be unnecessary and lead to hours' worth of time wasted each year. Ongoing research will further investigate the utility of drying the antiseptic after application and its affect on not only preventing ignition but also antimicrobial efficacy.</abstract><cop>England</cop><pmid>38850224</pmid><doi>10.1093/milmed/usae300</doi><orcidid>https://orcid.org/0009-0005-6878-087X</orcidid></addata></record> |
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source | Oxford University Press Journals All Titles (1996-Current); MEDLINE |
subjects | Animals Anti-Infective Agents, Local - administration & dosage Anti-Infective Agents, Local - therapeutic use Electrosurgery - instrumentation Electrosurgery - methods Electrosurgery - standards Fires - prevention & control Fires - statistics & numerical data Humans Operating Rooms - methods Operating Rooms - standards Swine Time Factors |
title | The Dreaded 3-Minute Wait: Does It Really Prevent Operating Room Fires? The IGNITE Trial |
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