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Health Care Safety

Bringing to Light the Risk of Burns From Retained Metal Jewelry Piercings During Electrosurgery—Torching the Myth

Educational Objective
To identify the key insights or developments described in this article

1 Credit CME

JAMA Surgery

Published Online: March 2, 2022

JAMA Network Insights

Article Information and Disclosures

Nicole Blumenstein, MD¹;

Johanna Wickemeyer, MD¹;

Ari Rubenfeld, MD¹

Author Affiliations

¹Department of Otolaryngology–Head and Neck Surgery, University of Illinois at Chicago, Chicago

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Many perioperative protocols require the removal of metal jewelry piercings prior to surgeries that use electrosurgical tools, such as monopolar cautery.¹^,2 However, case delays or cancellations can occur when jewelry is not removed prior to undergoing anesthesia. If patients have personal reasons for retaining their jewelry, then jewelry removal may incur more harm to the patient. Little is known about the risk of distant burns to patients who wear metal jewelry, such as piercings, while undergoing procedures with modern electrosurgical equipment. Studies report that the incidence of patients entering the operating room with metal piercings is small.³^,4 Furthermore, to our knowledge, there are no published case reports of alternate site burns owing to metal piercings.

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Article Information

Corresponding Author: Ari Rubenfeld, MD, Eye and Ear Infirmary, 1855 W Taylor St, 387 EEI MC 648, Chicago, IL 60612 (abr2@uic.edu).

Published Online: March 2, 2022. doi:10.1001/jamasurg.2022.0110

Conflict of Interest Disclosures: None reported.

References

Croke L . Guideline quick view: electrosurgical safety. AORN J. 2020;112(4):430-434. doi:10.1002/aorn.13221 PubMed Google Scholar Crossref

Cordero I . Electrosurgical units—how they work and how to use them safely. Community Eye Health. 2015;28(89):15-16.PubMed Google Scholar

Diccini S , Nogueira AM , Sousa VD . Body piercing among Brazilian surgical patients. AORN J. 2009;89(1):161-165. doi:10.1016/j.aorn.2008.07.003 PubMed Google Scholar Crossref

Vilos GA . Understanding and practising safe electrosurgery in the operating room. J Obstet Gynaecol Can. 2018;40(10):1337-1347. doi:10.1016/j.jogc.2018.03.004 PubMed Google Scholar Crossref

Stewart C . Global electrosurgical device market share by company globally 2016. Statista. Accessed January 7, 2021. https://www.statista.com/statistics/909626/electrosurgical-devices-market-share-by-top-company/

Deml MC , Goost H , Schyma C , Kabir K , Hoppe S , Deborre C . Thermic effect on metal body piercing by electrosurgery: an ex vivo study on pig skin and bovine liver. Technol Health Care. 2018;26(2):239-247. doi:10.3233/THC-160706 PubMed Google Scholar Crossref

Sheldon RR , Loughren MJ , Marenco CW , et al. Microdermal implants show no effect on surrounding tissue during surgery with electrocautery. J Surg Res. 2019;241:72-77. doi:10.1016/j.jss.2019.03.039 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.