title: Accidental burns during surgery.
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.
authors.affiliation: Department of Plastic and Hand Surgery, Burn Center, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: Erhan
authors.initials: E
authors.lastname: Demir
authors.forename: Dan Mon
authors.initials: DM
authors.lastname: O'Dey
authors.forename: Norbert
authors.initials: N
authors.lastname: Pallua
mesh_terms: D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000009:adverse effects; D002053:Burn Units; D002056:Burns / Q000209:etiology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D001026:Coronary Artery Bypass; D003646:Debridement; D004566:Electrodes / Q000009:adverse effects; D004598:Electrosurgery / Q000009:adverse effects / Q000295:instrumentation; D004868:Equipment Failure; D005112:Extracorporeal Circulation; D005260:Female; D005858:Germany; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011206:Povidone-Iodine / Q000008:administration & dosage / Q000009:adverse effects; D012837:Silver Sulfadiazine / Q000008:administration & dosage; D016038:Skin Transplantation; D013524:Surgical Flaps
chemical_list: D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine; D012837:Silver Sulfadiazine