The presented paper effectively explores the significant causes of surgical thermal burns/perioperative hypothermia and recommends evidence-based preventive strategies in the context of reducing the frequency of patients' burns' episodes in the surgical settings. The literature review explores a range of research articles that describe potential causes of intraoperative thermal burns in the surgical setting.

Introduction

Surgical thermal burns reveal the preventable injuries that occur under the impact of a range of significant surgical interventions. Electrocautery burns in surgical settings usually result from the inappropriate utilization of the grounding pads on the skin surface of the treated patients (Saaiq, Zaib, & Ahmad, 2012). The loosening of the grounding pad results in sparkling and generation of heat over the skin surface that fails to safely exit via the desired circuit. This leads to the occurrence of severe skin injuries that predispose the traumatized skin towards infections and inflammation. The surgical prep solutions configured from the alcohol base significantly elevate the risk of thermal skin burns and surgical field fire (Patel, Chavda, & Hukkeri, 2010). The surgical thermal burns disproportionately impact the skin surface of the affected patients. They predispose the affected patients towards life-threatening sepsis that requires multiple surgical interventions and lengthy hospitalization (Abu-Sittah, El-Khatib, & Dibo, 2011). Electrosurgery applications in the operating rooms also elevate the risk of electrical burns. 

Significant factors including alcohol, ethyl chloride, and oxygen utilization, earthing, defective rubber flooring, operating bed coats, isolated power system, currents' leakage, and other similar defects in the electrosurgery units substantially elevate the risk of electrosurgery burns across the surgical units (Jalali, Moradi, & Ghanbari, 2015). The electrocautery burns also occur due to the active electrodes' accidental contact with the skin surface, electric circuit's broken insulation and its contact with the patient skin, or availability of the inflammable antiseptic cleansing agent near the electrocautery apparatus (Gupta, Kumar, Bansal, & Mehta, 2011). The presented paper effectively explores the significant causes of surgical thermal burns/perioperative hypothermia and recommends evidence-based preventive strategies in the context of reducing the frequency of patients' burns' episodes in the surgical settings. The literature review explores a range of research articles that describe potential causes of intraoperative thermal burns in the surgical setting. Accordingly, the mitigative methods will need to be configured to challenge the occurrence of surgical thermal burns in the operative facility.      

Hypothesis 

Controlled use/avoidance of alcohol-based solution and compliance to the burn prevention protocols are highly required to reduce the risk and frequency of surgical thermal/intraoperative burns or chemical/electrocautery-based burns in the surgical settings.   

Background

The quantitative assessment by (Demir, O’Dey, & Pallua, 2006) reveals the use of betadine solution (during skin preparation), the creation of the alternative current pathways, moisture-based negative electrodes, inappropriate electrode positioning, & electrosurgical device malfunction as the significant causes of intraoperative thermal burns. Appropriate use of electrosurgical devices in the surgical setting leads to the selective cauterization of the desired skin surface through the controlled dissipation of the electric currents that minimize the risk of unintended thermal burns. The surgeons recommend the appropriate use of grounding pads to effectively reduce the risk of surgical thermal burns in predisposed patients (Bae, Lee, & Park, 2018). The intraoperative burns significantly elevate the risk of altered pharmacology, hypothermia, rapid blood loss, vascular access, impaired lung function, and airway abnormalities (Bittner, Shank, Woodson, & Martyn, 2015). The assessment by (Cordero, 2015) reveals the improper contact between the monopolar return electrode and the patient's skin as one of the significant factors for surgical thermal burns in the operative settings. The use of rubber sheathing and cables over the electrode tip and metal instruments in the electrosurgical units substantially elevate the risk of surgical thermal burns in the intraoperative setting (Cordero, 2015). Holes in the sterile gloves and use of the electrosurgical equipment with the wet hands also elevate the risk of electrical current leakage across the patient's skin surface that eventually leads to the occurrence of thermal burns during the operative intervention. Furthermore, the administration of electrosurgical equipment through the wet surface also increases the risk of short circuit and resultant thermal burns across the patient's skin (Cordero, 2015). These findings reveal the significant intraoperative thermal burn-related factors that require evidence-based mitigation to facilitate the safe administration of a range of significant electrosurgical procedures electrosurgical or laser procedures in the operative settings.     

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