Case Report
Full-Thickness Forehead Burn Over Indwelling Titanium Hardware Resulting From an Aberrant Intraoperative Electrocautery Circuit
Gerhard S. Mundinger, BS,a Shai M. Rozen, MD,b Benjamin Carson, MD,c Robert S. Greenberg, MD,d and Richard J. Redett, MDe

aJohns Hopkins School of Medicine, Baltimore, MD; bDivision of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, MD; cDepartment of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, MD; dDepartment of Anesthesia and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD; eDivision of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, MD



Correspondence: rredett@jhmi.edu

Objective: This study aims to contextualize an unintended intraoperative electrocautery burn that occurred on our service within the spectrum of all intraoperative electrocautery burns. Methods: A case report of the incident was drafted, and the relevant literature present in PubMed and industry publications was reviewed. Results: Intraoperative electrocautery burns can be divided into 4 categories: (1) direct contact burns resulting from inappropriate operator use of the active electrode, (2) burns at the grounding electrode site due to improper attachment or placement, (3) burns resulting from electrode heating of pooled solutions, and (4) burns occurring outside the operative field as a result of circuits generated between the active electrode and an alternate grounding source. We herein report an unintended intraoperative electrocautery burn of the fourth category. An aberrant intraoperative circuit utilized previously placed in-dwelling titanium plating in the  .......