THE ABILITY OF ARTHROSCOPIC EQUIPMENT TO PRODUCE THERMAL BURNS. SIMPLE RECOMMENDATIONS TO AVOID COMPLICATIONS

H Sandhu; R Turner; J Pozo

doi:10.1302/0301-620X.84BSUPP_II.0840158a

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THE ABILITY OF ARTHROSCOPIC EQUIPMENT TO PRODUCE THERMAL BURNS. SIMPLE RECOMMENDATIONS TO AVOID COMPLICATIONS

H Sandhu
R Turner
J Pozo

THE ABILITY OF ARTHROSCOPIC EQUIPMENT TO PRODUCE THERMAL BURNS. SIMPLE RECOMMENDATIONS TO AVOID COMPLICATIONS

Sandhu H, Turner R, Pozo J. THE ABILITY OF ARTHROSCOPIC EQUIPMENT TO PRODUCE THERMAL BURNS. SIMPLE RECOMMENDATIONS TO AVOID COMPLICATIONS. Orthop Procs. 2002;84-B(SUPP_II):158-158. doi:10.1302/0301-620X.84BSUPP_II.0840158a

Sandhu, H, et al. “THE ABILITY OF ARTHROSCOPIC EQUIPMENT TO PRODUCE THERMAL BURNS. SIMPLE RECOMMENDATIONS TO AVOID COMPLICATIONS.” Orthopaedic Proceedings, vol. 84-B, no. SUPP_II, 2002, pp. 158-158., https://doi.org/10.1302/0301-620X.84BSUPP_II.0840158a

Sandhu, H., Turner, R., & Pozo, J. (2002). THE ABILITY OF ARTHROSCOPIC EQUIPMENT TO PRODUCE THERMAL BURNS. SIMPLE RECOMMENDATIONS TO AVOID COMPLICATIONS. Orthopaedic Proceedings, 84-B(SUPP_II), 158-158. https://doi.org/10.1302/0301-620X.84BSUPP_II.0840158a

Sandhu, H., Turner, R. and Pozo, J. (2002) “THE ABILITY OF ARTHROSCOPIC EQUIPMENT TO PRODUCE THERMAL BURNS. SIMPLE RECOMMENDATIONS TO AVOID COMPLICATIONS.” Orthopaedic Proceedings, 84-B(SUPP_II), pp. 158-158. Available at: https://doi.org/10.1302/0301-620X.84BSUPP_II.0840158a

Sandhu, H, R Turner, and J Pozo. “THE ABILITY OF ARTHROSCOPIC EQUIPMENT TO PRODUCE THERMAL BURNS. SIMPLE RECOMMENDATIONS TO AVOID COMPLICATIONS.” Orthopaedic Proceedings 84-B, no. SUPP_II (2002): 158-158. https://doi.org/10.1302/0301-620X.84BSUPP_II.0840158a

Sandhu H, Turner R, Pozo J. THE ABILITY OF ARTHROSCOPIC EQUIPMENT TO PRODUCE THERMAL BURNS. SIMPLE RECOMMENDATIONS TO AVOID COMPLICATIONS. Orthop Procs. 2002 Jul 1;84-B(SUPP_II):158-158. https://doi.org/10.1302/0301-620X.84BSUPP_II.0840158a

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Abstract

Introduction: Knee arthroscopy is one of the most commonly performed orthopaedic procedures. All orthopaedic surgeons have heard anecdotal stories of thermal injury and drape combustion, yet a literature search has failed to find any papers reviewing the nature of such risks.

Materials and methods: A thermocouple attached to a laptop computer was used to record the temperature at the arthroscope tip, the light cable end and the light source generator. All potentially flammable materials commonly used during arthroscopic surgery (various disposable drapes, cotton drapes, gowns, paper towels and swabs), were placed at measured distances from a) the light cable end and b) the arthroscope tip.

Results: The arthroscope tip reached a maximum temperature of 41.90° in 200 seconds. The light cable tip reached 80° at 100 seconds and a maximum temperature of 110°C in 342 seconds. The light source generator reached a temperature of 153°C. All materials tested (except cotton swabs) underwent signs of combustion. The disposable drapes burnt most rapidly. None of the materials considered had any evidence of thermal damage when placed at distances of 2.5 cm beyond the light cable and 0.5 cm beyond the arthroscope tip. Combustion was most rapid at a distance of 5mm from the instruments.

Most surgeons consider the arthroscope tip or light cable end to be the site most likely to induce combustion. Fuel, heat and oxygen are required to produce combustion. Direct contact with the tip results in greater exposure to heat but lower oxygen availability. The fasted combustion occurred at 5mm due to higher oxygen availability despite a lower temperature.

Conclusions and Recommendations:

Disposable drapes will burn with the light cable and the arthroscope tip.
The arthroscope tip and light cable end should not be left to rest against the drapes because thermal burns can occur within seconds.
A kidney dish should be used to contain the instruments when not in the surgeon’s hands.
The light source should be switched on only when the light cable is connected to the arthroscope.
A retractable shield of 2.5mm is fitted to the light cable end.

The abstracts were prepared by Mr R. B. Smith. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN.