Preventing and Managing Operating Room Fires in Plastic Surgery: A Review of Incidence, Risk Factors, and Recommendations With Case Experiences.

This article focuses on the incidence, risk factors, prevention, and management of operating room fires, particularly in plastic surgery and head and neck procedures. Operating room fires require the simultaneous presence of three elements—oxidizer (oxygen or nitrous oxide), ignition source (e.g., electrocautery devices or lasers), and fuel (such as drapes or alcohol-based antiseptics)—collectively known as the "fire triad." The review highlights that most surgical fires occur near the head, neck, and upper chest, with high-risk procedures including tonsillectomies and facial surgeries. Prevention strategies emphasize multidisciplinary communication, minimizing oxygen concentration, using fire-resistant materials, and careful handling of ignition sources, while management involves immediate fire recognition, extinguishing flames, airway protection, and postfire care. The article underscores the need for ongoing staff training, institutional safety protocols, and further research to better quantify risks and optimize fire prevention and response in surgical settings.