What safety practices reduce the risk of surgical fires in the OR?

• A. Use high oxygen concentration for all cases.
• B. Minimize ignition sources near oxidizers, ensure proper use of cautery, avoid alcohol-based prep on surgical sites; maintain appropriate oxygen concentration.
• C. Always use alcohol-based prep on open incisions.
• D. Ignition sources are not a concern in the OR.

Answer: (B)

Preventing surgical fires hinges on limiting fuel, reducing oxidizers, and controlling ignition sources. The safest approach is to minimize ignition sources near oxidizers, use cautery devices properly to prevent unintended sparks, avoid alcohol-based prep on surgical sites, and keep oxygen concentration at the lowest level that maintains patient safety. Alcohol-based prep can leave flammable residue and ignite if oxygen is present nearby, so non-alcohol preparations or ensuring the prep dries completely is preferred around the incision. Electrosurgical devices and lasers are powerful ignition sources and should be used with appropriate settings, proper technique, and with dry drapes and prep solutions kept away from the field. Maintaining a lower FiO2 in cases that permit it reduces the oxidizer available for a fire. The other statements either increase risk by raising oxygen concentration in all cases, promote a risky prep method on open incisions, or ignore the importance of ignition sources in the OR, all of which fail to address the elements that contribute to a surgical fire.