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Surgical Fire Risk in Mohs Surgery is Minimal

Dermatolog Surg; ePub 2018 Sep 17; Li, et al

The overall risk of surgical fire in Mohs micrographic surgery (MMS) is minimal, according to a recent study. However, safety measures and greater awareness of fire risks are necessary to prevent patient harm. An internet survey was developed and sent to American College of Mohs Surgeons (ACMS) members. Data collected included total years of experience, total number of cases, typical management of supplemental oxygen, and surgical fires experienced. Researchers found:

  • 80 participants contributed data on 886,200 cases of MMS.
  • 9 surgeons (11%) reported at least 1 surgical fire, yielding an estimated incidence of 1 fire per 88,620 cases (0.001%).
  • The most common site of involvement was the scalp (67%).
  • Common ignition sources included monopolar electrosurgical devices (78%) and battery-powered thermal cautery (22%).
  • Fuel sources included towels or drapes, gauze, isopropyl alcohol, aluminum chloride, hairspray, and diethyl ether.
  • Supplemental oxygen was not involved in any of the cases.
  • 5 patients suffered singed hair while 4 patients did not suffer any injuries.
  • None suffered any permanent functional or aesthetic deformities.


Li J, Kampp JT. Fire safety in Mohs micrographic surgery. [Published online ahead of print September 17, 2018]. Dermatolog Surg. doi:10.1097/DSS.0000000000001681.