In addition to the right choice of product, instruction and correct usage are important in preoperative skin disinfection with disinfectants containing alcohol to avoid burns caused by electrical devices (e.g. electrosurgical pencil) or irritation.
Betaseptic and burns
Incident data |
Description |
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Case 2023 Age group: Adult (>/= 18 years) Sex: Male Medicinal product: Betaseptic® Active substances: Ethanol, propanol, povidone-iodine Indication: Preoperative skin disinfection ADR: Burn Outcome: recovering |
Prior to abdominal surgery, the skin around the surgical site was disinfected. While an electrosurgical pencil was being used, the patient's skin ignited (flame) resulting in 2b degree burns to the right side of the neck and third degree burns to the right shoulder. The burns had to be excised by the plastic surgeon. A defect reconstruction was performed on the burn to the shoulder using bilateral advancement flaps.
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Case 2009 Age: Adult (>/= 18 years) Sex: Male Medicinal product: Betaseptic® Active substances: Ethanol, propanol, povidone-iodine Indication: Preoperative skin disinfection ADR: Burn Outcome: recovered |
During inguinal hernia surgery, the incision was made while the skin was still moist. When the surgical site was being prepared with an electrosurgical pencil, flames formed. The patient suffered second degree burns. The burns were treated locally with medical gauze. The burns healed without scar formation. |
Case 2005 Age: Child (</= child) Sex: Male Medicinal product: Betaseptic® Active substances: Ethanol, propanol, povidone-iodine Indication: Preoperative skin disinfection ADR: Burn Outcome: recovered with sequelae |
One day after abdominal surgery, a painful burn site appeared in the lumbar region. Skin debridement and wound treatment were performed. A differential diagnosis considered a chemical burn or an electrical burn following disinfection and the liquid running down and accumulating in the lumbar region. |
Summary and recommendation
Disinfectants such as Betaseptic®, Octeniderm® and Softasept® N are used in surgical and diagnostic interventions, and are highly flammable due to their high alcohol content. Burns can result if electrical devices are used before the disinfectant dries. In addition, accumulation of the substance in skin folds or underneath the recumbent patients can occur during preoperative skin disinfection.
The “Warnings” and “dosage/administration” sections of the relevant information for healthcare professionals mention that the solution must be completely dried and “pooling” under the recumbent patient must be avoided during preoperative skin disinfection and before use of electrical devices (particularly surgical high frequency devices).
Healthcare professionals are requested to report serious and/or previously unknown adverse drug reactions to Swissmedic. Please use the Electronic Vigilance Reporting Portal “ElViS” for this purpose.
Supplementary information
Swissnoso Sample Guidelines: preoperative skin disinfection [in German]
Guidelines of the National Centre for Infection Prevention on responsibilities, material requirements and process for preoperative skin disinfection
(www.swissnoso.ch)
(www.swissnoso.ch)
Electronic reports via the ElVis portal