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November 17, 1993

Thermocautery Causes a Gauze Pad Fire

JAMA. 1993;270(19):2299-2300. doi:10.1001/jama.1993.03510190053017

To the Editor.  —We write to alert surgeons of a possible danger from using disposable, battery-powered, hand-held thermocautery units near dry gauze sponges in the operative field.A patient presented to the ambulatory surgery operative suite for excision of a keloid on the right ear. Once the patient was prepared, draped, and given local anesthetic, and the keloid was excised, a hand-held, disposable, battery-operated thermocautery unit was used to provide hemostasis around the skin edge of the operative site. When the cautery was at full temperature, it inadvertently touched a thread of a dry, 4×4 surgical gauze pad that was used to hold back the skin edges. The gauze rapidly was engulfed in flame. It was grasped and thrown to the floor, where the fire was extinguished by stepping on the flame. No injury was sustained by the patient or surgeons.This incident highlights the convenience of and the caution