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Did Skin Prep Fuel This Fire? - February 2017 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Putting Things Into Their Proper Perspective A surgical fire, appropriate OR attire and UnitedHealth's empire. T he more we looked into the case of Jeanne Holden, the 86-year- old surgical fire burn victim on the cover, the more confused we got. This much we know: Ms. Holden is suing an Oregon sur- gical center for $1 million, alleging that her face caught fire during a temporal artery biopsy. We first reported online that the fire was due to a wet surgical skin prep, even though the lawsuit blamed it on an "anesthetic" (perhaps mistaken for "antiseptic?"). When we called Ms. Holden's legal team, a representative told us that the OR team didn't let the chlorhexidine glu- conate skin prep that had been applied to her face dry before they closed the incision with an electrosurgical cauterizing probe. But when we followed up again to get more details for "Did Skin Prep Fuel This Fire?" on page 22, Ms. Holden's lawyer told us "there's a level of uncertainty" as to what caused the fire and could not confirm that the skin prep was involved. Ms. Holden's family and a national expert who has researched the causes and prevention of surgical fires for more than 40 years strongly suspect that the fire was caused by supplemental oxygen. "You never, ever cauterize an incision with oxygen on for obvious reasons," says Katrina Staigle, Ms. Holden's daughter. Whatever the reason, you have a wholly preventable surgical fire from which to learn. Even though only a fraction of surgical fires involve alco- hol-based skin preps, Michael Barts, CRNA, of Havre, Mont., was around to witness one early in his career (not his case, he says). In 1983, a Canton, Ill., surgeon was removing skin tags with a cautery pencil. "The circulator told the surgeon no, but the surgeon did his own skin prep and plugged the cautery stick back into the machine," he says. "A low blue flame consumed the paper drapes. The fire department responded in turnout gear dragging a charged hose." 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • F E B R U A R Y 2 0 1 7 Editor's Page Dan O'Connor

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