Patients are routinely asked to remove jewelry before undergoing surgery. This is a crucial safety measure, implemented to prevent potential complications and ensure a safe surgical environment.
Protecting Patient Safety
A significant reason for jewelry removal involves electrocautery devices, which use electricity to precisely cut tissue and control bleeding. Metal jewelry, including rings, earrings, necklaces, and body piercings, can act as a conductor for this electrical current. If electricity travels through jewelry, it can concentrate the current and lead to severe burns on the skin.
Jewelry can also harbor bacteria and other microorganisms. It is challenging to adequately sterilize jewelry, and its presence can increase the risk of surgical site infections by introducing pathogens into the sterile operating field. Studies show that rings, for instance, can maintain a higher microbial load on the skin underneath them, even after hand hygiene.
Post-operative swelling is a common occurrence after surgery. If tight jewelry, particularly rings or bracelets, is not removed, it can become constrictive as the body swells. This constriction can impede blood circulation, potentially causing pain, tissue damage, or even necessitating emergency removal.
Maintaining a Safe Surgical Environment
Metal jewelry can interfere with diagnostic imaging procedures. During Magnetic Resonance Imaging (MRI), powerful magnets can attract ferromagnetic metals, causing them to move forcefully or heat up, which poses a risk of injury and can distort image quality. Similarly, during X-rays, metal jewelry can obscure views or create artifacts, making accurate interpretation difficult and potentially requiring repeat imaging.
Jewelry also presents physical hazards within the sterile operating room. It can snag on surgical drapes, medical equipment, or the surgeon’s gloves, potentially causing tears to the patient’s skin or compromising the sterile field. There is also a risk of jewelry getting caught in machinery, which could cause injury to staff or damage expensive equipment. Furthermore, quick and unobstructed access to the patient’s body is paramount in an emergency, and jewelry can impede this access.
Valuable jewelry can be lost or damaged during a surgical procedure. While precautions are taken, the risk of misplacement or damage exists due to the necessary movements and procedures involved.
Addressing Unremovable Jewelry
In some cases, jewelry cannot be easily removed, such as rings stuck due to chronic swelling or certain permanent body piercings. Hospitals have established protocols to mitigate these risks. One common solution involves taping over the jewelry with medical tape to insulate it, particularly when electrocautery is used. This helps prevent the jewelry from conducting electrical current and causing burns.
For body piercings, non-conductive retainers made of materials like PTFE or Bioplast can be used as a temporary replacement for metal jewelry. These materials are non-metallic and flexible, making them safe for MRI and other procedures where metal is a concern. In instances of severe swelling with a stuck ring that compromises circulation, a ring cutter might be used as a last resort to safely remove the item. Patients should communicate any difficulties in removing jewelry to their healthcare team well in advance of their surgery date. This allows the medical staff to plan appropriate measures and discuss available options.