DuraPrep and the risk of fire during tracheostomy.
BACKGROUND
DuraPrep is a widely used, alcohol-based surgical prep solution. The risk of surgical fire associated with incomplete drying of this agent in the context of electrosurgical procedures has been described previously. To date, there have been no reports of fire during tracheostomy associated with a flammable prep agent before entering the airway. We describe an operating room fire occurring during awake tracheostomy associated with the use of DuraPrep.


METHODS
A 62-year-old man with copious body hair underwent tracheostomy in the operating room. The neck was prepared with DuraPrep surgical solution, and after at least 3 minutes, the operative field was draped. Activation of electrocautery ignited a fire, and the patient was burned on his neck and shoulders.


RESULTS
The fire was extinguished, and the patient recovered from both the tracheostomy and the burns.


CONCLUSIONS
This case illustrates that DuraPrep should be avoided in the hirsute patient, because body hair interferes with drying of this solution and increases the risk of fire.
Weber
Stephen M
SM
Department of Otolaryngology and Head & Neck Surgery, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Road, Portland, Oregon 97239, USA.
Hargunani
Christopher A
CA
Wax
Mark K
MK
D019840:2-Propanol / Q000009:adverse effects*; D004564:Electrocoagulation / Q000009:adverse effects*; D000431:Ethanol; D005390:Fires; D006197:Hair; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D007442:Intubation, Intratracheal; D007455:Iodine / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014139:Tracheostomy
C515331:DuraPrep; D000431:Ethanol; D007455:Iodine; D019840:2-Propanol