incidence of operating room fires during hand surgical procedures

Background: the purpose of the present study is to report the incidence of operating room fires during hand surgical procedures. methods: the clinic and or electronic medical records of seven fellowship-trained orthopedic hand surgeons at a single, large practice were retrospectively reviewed. all upper extremity procedures performed between june 2014 to june 2019 in both hospital and surgery center settings were included in the review. demographic data was collected. the incidence of operating room fires was determined. results: a total of 18,819 hand and upper extremity surgical procedures were included. there were 16,767 (89.1%) cases performed in a surgery center, while 2,052 (10.9%) of cases were performed in a hospital. there were 12,691 (67.4%) soft tissue procedures and 6,127 (32.6%) bony procedures performed. chlorhexidine gluconate preparation solution was used in 9607 cases (51%). chloraprep solution was used in 6280 cases (33.4%). betadine was used in 2,932 cases (15.6%). one surgeon has monopolar electrocautery only available during cases. five surgeons have bipolar available, and one has both mono and bipolar electrocautery available. there were no fires (0%) identified during the study period. conclusion: the incidence of operating room fires during hand surgical procedures is extremely low. while hand surgeons can be reassured that the likelihood of an operating room fire is minimal, surgeons should not become complacent and should maintain a high level of vigilance to prevent these potentially devastating occurences.