It is a universal safety protocol that jewelry, particularly metal earrings and other piercings, must be removed before nearly all surgical procedures. This requirement applies regardless of the surgery’s location on the body, extending even to minor outpatient procedures. The practice is enforced to prevent serious complications that can arise from having conductive materials on the patient during the operation.
Standard Policy for Pre-Surgical Jewelry Removal
Hospital policy requires the removal of all personal adornments, including earrings, rings, necklaces, and all body piercings, before a patient is transferred to the operating theater. This protocol is mandatory for both small studs and larger hoops, as the rule is based on the material’s properties rather than its size. The removal is necessary to maintain a controlled environment for patient safety. Removing jewelry also prevents physical complications that may occur during the procedure, such as swelling causing tight earrings or rings to constrict circulation or become painfully embedded in the tissue. Additionally, valuable items introduce liability and the risk of loss or damage, which hospitals seek to avoid.
Crucial Safety Risks Associated with Metal Jewelry
The primary and most serious risk associated with metal jewelry during surgery involves the use of electrosurgical units (ESUs), commonly known as electrocautery devices. These devices pass a high-frequency electrical current through the patient’s tissue to cut, seal blood vessels, and control bleeding. Metal jewelry acts as a conductor, and if it provides an unintended pathway for the current, it can cause severe thermal burns at the contact point. This burn hazard occurs if there is a fault in the ESU’s grounding system, causing the current to bypass the intended return pad and seek a path through the metal on the patient’s body. Even a small earring can concentrate the electrical energy, leading to a burn injury that may be difficult to detect under surgical drapes.
Beyond the electrical risk, jewelry provides an ideal surface for bacterial accumulation, creating a biofilm that is difficult to sterilize. Introducing these bacteria into the sterile field or a surgical incision increases the risk of developing a post-operative wound infection. Jewelry also poses a risk of physical obstruction, where it can snag on surgical drapes, wires, or instruments. This snagging could cause accidental tearing of the pierced site or dislodge the item into the surgical field. In an emergency, jewelry can impede medical staff’s access to the patient, potentially delaying life-saving interventions.
Alternatives for Non-Removable Piercings
For newly placed piercings or those that cannot be easily removed, non-metallic retainers offer a safe alternative to metal jewelry, typically made from biocompatible materials like polytetrafluoroethylene (PTFE), Bioflex, or glass. The non-conductive nature of these materials eliminates the risk of electrocautery burns while keeping the piercing channel open. Patients should purchase these retainers and replace their metal jewelry days before the procedure to avoid irritation on the day of surgery. If a piercing cannot be removed or replaced, patients must notify the surgical team beforehand to discuss options. In some cases, if the jewelry is near the surgical site, it may be securely taped in place with medical-grade adhesive tape, primarily to prevent snagging and loss, not to insulate against electrical current.