Online Articles: Technical ReportsSurgical Smoke Evacuators Reduce the Risk of Fires From Alcohol-Based Skin PreparationsCarmichael, Heather MD*; Samuels, Jason M. MD*; Wikiel, Krzysztof J. MD†; Robinson, Thomas N. MD, MS†; Barnett, Carlton C. Jr MD†; Jones, Teresa S. MD†; Jones, Edward L. MD†Author Information *Department of Surgery, University of Colorado †Department of Surgery, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO The authors declare no conflicts of interest. Reprints: Heather Carmichael, MD, 12631 E. 17th Avenue, C-305, Aurora, CO 80045 (e-mail: [email protected]). Surgical Laparoscopy, Endoscopy & Percutaneous Techniques: December 2019 - Volume 29 - Issue 6 - p e94-e97 doi: 10.1097/SLE.0000000000000734 Buy Metrics Abstract Surgical smoke evacuators may reduce the concentration of alcohol vapors from skin preparations at the site of electrosurgical device activation, decreasing operating room fire risk. Our aim was to compare the incidence of flames with and without smoke evacuation in a porcine ex vivo model. A monopolar device was activated after application of either 70% isopropyl alcohol/2% chlorhexidine gluconate (CHG-IPA) or 74% isopropyl alcohol/0.7% iodine povacrylex (iodine-IPA) skin preparations. No suction was compared with standard wall suction and 2 monopolar devices with built-in smoke evacuators. Flames were generated in 60% of CHG-IPA and 47% of iodine-IPA tests without suction. Wall suction did not significantly reduce fires (CHG-IPA 43% vs. 60%, P=0.30; iodine-IPA 57% vs. 47%, P=0.61). Use of both smoke evacuation devices reduced fires for CHG-IPA (17% vs. 60%, P=0.001 and 20% vs. 60%, P=0.004) but not for iodine-IPA. Smoke evacuation devices reduce fire risk when used with a chlorhexidine-alcohol skin preparation. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.