Connor Michael A, Menke Anne M, Vrcek Ivan, Shore John W
Oculoplastic and Orbital Consultants, West Palm Beach, FL, USA.
Ophthalmic Mutual Insurance Company, San Francisco, CA, USA.
Int Ophthalmol. 2018 Jun;38(3):1085-1093. doi: 10.1007/s10792-017-0564-9. Epub 2017 May 20.
A survey of ophthalmic plastic and reconstructive surgeons as well as seven-year data regarding claims made to the Ophthalmic Mutual Insurance Company (OMIC) is used to discuss operating room fires in periocular surgery.
A retrospective review of all closed claim operating room fires submitted to OMIC was performed. A survey soliciting personal experiences with operating room fires was distributed to all American Society of Oculoplastic and Reconstructive Surgeons.
Over the last 2 decades, OMIC managed 7 lawsuits resulting from an operating room fire during periocular surgery. The mean settlement per lawsuit was $145,285 (range $10,000-474,994). All six patients suffered burns to the face, and three required admission to a burn unit. One hundred and sixty-eight surgeons participated in the online survey. Approximately 44% of survey respondents have experienced at least one operating room fire. Supplemental oxygen was administered in 88% of these cases. Most surgical fires reported occurred in a hospital-based operating room (59%) under monitored anesthesia care (79%). Monopolar cautery (41%) and thermal, high-temperature cautery (41%) were most commonly reported as the inciting agents. Almost half of the patients involved in a surgical fire experienced a complication from the fire (48%). Sixty-nine percent of hospital operating rooms and 66% of ambulatory surgery centers maintain an operating room fire prevention policy.
An intraoperative fire can be costly for both the patient and the surgeon. Ophthalmic surgeons operate in an oxygen rich and therefore flammable environment. Proactive measures can be undertaken to reduce the incidence of surgical fires periocular surgery; however, a fire can occur at any time and the entire operating room team must be constantly vigilant to prevent and manage operating room fires.
通过对眼科整形与重建外科医生进行调查以及分析向眼科互助保险公司（OMIC）提出索赔的七年数据，来讨论眼周手术中的手术室火灾问题。
对所有提交给OMIC的已结案的手术室火灾索赔进行回顾性分析。向美国眼整形与重建外科学会的所有成员发放了一份关于手术室火灾个人经历的调查问卷。
在过去20年中，OMIC处理了7起因眼周手术期间手术室火灾引发的诉讼。每起诉讼的平均和解金额为145,285美元（范围为10,000 - 474,994美元）。所有6名患者面部均有烧伤，3人需要入住烧伤病房。168名外科医生参与了在线调查。约44%的受访者至少经历过一次手术室火灾。其中88%的病例使用了辅助氧气。报告的大多数手术火灾发生在医院手术室（59%），处于监护麻醉下（79%）。最常被报告为起火源的是单极电灼（41%）和热的、高温电灼（41%）。几乎一半参与手术火灾的患者因火灾出现了并发症（48%）。69%的医院手术室和66%的门诊手术中心制定了手术室防火政策。
术中火灾对患者和外科医生来说代价都很高。眼科医生在富含氧气因而易燃的环境中进行手术。可以采取积极措施降低眼周手术中手术火灾的发生率；然而，火灾随时可能发生，整个手术室团队必须时刻保持警惕，以预防和处理手术室火灾。
