Thermal injury to common operating room materials by fiber optic light sources and endoscopes

• Published in: American journal of otolaryngology Vol. 40; no. 5; pp. 631 - 635
• Main Authors: Prasad, Navin, Tavaluc, Raluca, Harley, Earl
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2019; Elsevier Limited
• Subjects: Bone surgery; Burn injury; Burning; Burns - epidemiology; Burns - etiology; Cables; Contact; Cotton; Endoscopes; Endoscopes - adverse effects; Equipment Design; Equipment Safety; Fiber optic technology; Fiber optics; Financial disclosure; Health risks; Heat; Heat sources; Hot Temperature - adverse effects; Humans; Iatrogenic Disease; Incineration; Injury prevention; Light; Light - adverse effects; Light intensity; Light sources; Luminous intensity; Models, Theoretical; Operating Rooms; Optical fibers; Optical Fibers - adverse effects; Otolaryngology; Patient Safety; Permutations; Risk Assessment; Smell; Smoking; Sponges; Surgical equipment; Thermal energy; Thermal injury; Towels; Ultrasonic testing; United States; Variables; Xenon; United States; Patient safety; Heat sources; Endoscopes; Fiber optic technology; Burn injury; Operating rooms
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2019.05.007

To determine the thermal energy damage potential by heat sources, such as endoscopes and fiber optic light cables, in contact with materials commonly placed around an operating room (OR) table. Injury by xenon and halogen light sources were tested by direct and indirect contact using fiber optic light bundle cables and scopes at light intensities between ranging from Standby to 100%. The scopes had diameters ranging from 2.7 mm to 10 mm and were set at varying angles. The materials tested were surgical drapes, cotton towels, child shirts, child pants, lap sponges, X-ray detectable sponges, and Mayo covers. The damage potential was determined qualitatively by presence of smoking or smell of burning. Permutations involving direct contact were able to cause thermal injury, while permutations involving indirect contact, endoscopes, or halogen lamp were not. The xenon light source with the fiber optic light cable created thermal injury at light intensities of 50%, 75%, and 100%. Time to injury increased as light intensity was decreased. Only the surgical drape, child shorts, and cotton towel showed evidence of burn injury. This report supports the potential for thermal injury to the patient secondary to fiber optic light sources, although this potential may be limited in extent. The injury risk can be reduced by avoiding direct contact to materials overlying the patient, confirming standby mode or 25% light intensity, and maintaining the endoscope connected to the fiber optic cable at all times.