A review of Enhancing Operating Room Safety: Protocols, Practices, and Preventative Measures

Abstract

Preventable medical errors significantly contribute to morbidity, mortality, and financial burden, with an estimated 44,000 to 98,000 deaths and $79 billion in costs annually in the United States. Ensuring patient safety in the operating room is crucial, particularly in plastic surgery procedures. Effective communication among surgical team members, utilizing crew resource management principles, and adhering to standardized protocols can substantially reduce errors. Proper patient positioning, considering individual risk factors and procedure-specific requirements, is essential to prevent complications such as peripheral neuropathies and pressure ulcers. Surgical hand antisepsis using alcohol-based hand rubs and patient skin preparation with alcohol-based agents combined with chlorhexidine are recommended to minimize infection risks. Consistent use of deep venous thromboembolism prophylaxis, maintaining normothermia, and prompt recognition and management of malignant hyperthermia are critical. Preventing operating room fires requires addressing the interplay between ignition sources, fuel sources, and oxidizers, while electrosurgical safety involves using modern dispersive electrode pads and avoiding flammable substances. Laser safety measures include eye protection, plume evacuation, and moist towels around the laser field. Standardized counting protocols and radiographic imaging when necessary can prevent retained surgical items. Pneumatic tourniquet use requires careful patient selection, proper cuff placement, and minimizing inflation pressures. Structured patient handoffs using models like SBAR (Situation, Background, Assessment, Recommendation) can reduce errors during transport. Implementing evidence-based safety practices and fostering a culture of communication and collaboration are essential for enhancing patient safety in the operating room.