Fire Prevention and Safety During Surgical Procedures

Substances that contain wax, paraffin or oil can burn. Petroleum jelly is a good example of an oil-based lubricant. For example, petroleum-based ointments used in an oxygen-enriched environment will ignite when enough heat is present to cause vaporization. These materials must vaporize and mix with oxygen to allow ignition. Large amounts of ointment are not easy to ignite because their mass absorbs considerable heat before vaporizing. Thin layers, however, have a low mass per area and need less heat to cause vaporization. Thus, they are more ignitable.

An unrecognized fuel- and oxygen-enriched atmosphere set the stage for a flash fire of the eyelid. Skin lesions were being removed from the patient's eyelid and neck. General anesthesia was administered by mask and was maintained with a 2:3 oxygen to nitrous oxide mixture and a small amount of halogenated anesthetic. An ophthalmic ointment was applied to the eyes. When the surgeon used an electrocautery device to remove a mole on the eyelid, a flash fire occurred. Quick control of the fire limited the patient's injury to only minor burns.

Care should be taken with substances that are administered with aerosols, as they also provide a fuel source. Additionally, collodion, a dressing material frequently used for pediatric cases, contains ether, alcohol and pyroxylin, which are highly flammable substances.

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