Burning Challenges: First case of burn injury during Trans-nasal Humidified Rapid-Insufflation Ventilatory Exchange
Kiran Narula1, Samantha Valvis1, Jeremy Rawlins1, 1State Adult Burns Unit, Fiona Stanley Hospital, Perth,, Western Australia, Australia
Abstract
Intro:
We present a case of an unanticipated operating theatre fire during an elective skin cancer surgery involving trans-nasal humidified rapid-insufflation ventilatory exchange (THRIVE).
Case Description:
A 60-year-old male underwent an elective skin cancer excision. During the procedure, THRIVE and bipolar diathermy were used which ignited resulting in a fire within the surgical field. The patient sustained 17% TBSA burns to the head, neck, and upper trunk.
The patient was transferred to the state adult burn unit for ongoing surgical management of the burn injuries. This included tangential debridement and reconstruction with split thickness skin graft and autologous keratinocyte cell suspension
Discussion:
To the authors’ knowledge, this is the first reported case of THRIVE contributing to a burn injury. Here we present the case, aetiology of injury, and pictorially discuss the resulting surgical challenges encountered during the burn wound management. Furthermore, we present the relevant literature, recommendations for prevention and the importance of remaining vigilant of fire hazards during surgery.
Biography
Kiran Narula is an unaccredited plastic surgery registrar from Perth, Western Australia. He has an interest in burns and head and neck surgery. In his spare time, he enjoys being outdoors and reading books, often combining the two!