title: Iatrogenic surgical microscope skin burns: A systematic review of the literature and case report.
abstract: Cutaneous burns associated with microscope-use are perceived to be uncommon adverse events in microsurgery. Currently, it is unknown what factors are associated with these iatrogenic events. In this report, we describe the case of a 1-year-old patient who suffered a full thickness skin burn from a surgical microscope after a L4-S1 laminectomy. Additionally, we present a systematic review of the literature that assessed the preoperative risk, outcome, and management of iatrogenic microscope skin burns. Lastly, a summary of the Food and Drug Administration's (FDA) Manufacturer and User Facility Device Experience (MAUDE) database of voluntary adverse events was reviewed and analyzed for clinical cases of microscope thermal injuries. The systematic literature review identified only seven articles related to microsurgery-related cutaneous burns. From these seven studies, 15 clinical cases of iatrogenic skin burns were extracted for analysis. The systematic review of the FDA MAUDE database revealed only 60 cases of cutaneous burns associated with surgical microscopes since 2004. Few cases of microscope burns have been described in the literature; this report is, to our knowledge, one of the first comprehensive reports of this iatrogenic event in the literature.
authors.affiliation: Department of Plastic & Reconstructive Surgery, Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, United States.
authors.forename: Joseph
authors.initials: J
authors.lastname: Lopez
authors.affiliation: Division of Plastic & Reconstructive Surgery, University of Washington Medical Center, 1959N.E. Pacific Street, Seattle, WA, United States.
authors.forename: Ashwin
authors.initials: A
authors.lastname: Soni
authors.affiliation: Department of Plastic & Reconstructive Surgery, Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, United States.
authors.forename: Daniel
authors.initials: D
authors.lastname: Calva
authors.affiliation: Department of Plastic & Reconstructive Surgery, Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, United States.
authors.forename: Srinivas M
authors.initials: SM
authors.lastname: Susarla
authors.affiliation: Department of Neurosurgery, Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, United States.
authors.forename: George I
authors.initials: GI
authors.lastname: Jallo
authors.affiliation: Department of Plastic & Reconstructive Surgery, Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, United States. Electronic address: rredett@jhmi.edu.
authors.forename: Richard
authors.initials: R
authors.lastname: Redett
mesh_terms: D002056:Burns / Q000209:etiology*; D065426:Cytoreduction Surgical Procedures; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007223:Infant; D007796:Laminectomy; D008067:Lipoma / Q000000981:diagnostic imaging / Q000601:surgery*; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D008591:Meningomyelocele / Q000000981:diagnostic imaging / Q000601:surgery*; D008853:Microscopy / Q000295:instrumentation*; D013115:Spinal Canal; D013523:Surgical Equipment / Q000009:adverse effects*
keywords: Iatrogenic burn; Microscope burns; Microsurgery; Surgical burns; Thermal injury