Full Thickness Burn on the Finger due to Pulse Oximetry during Magnetic Resonance Imaging in a Conscious Patient

Article information

Arch Plast Surg. 2016;43(6):612-613

Publication date (electronic) : 2016 November 18

doi : https://doi.org/10.5999/aps.2016.43.6.612

Seung Je Sung , Yong Sik Park , Jae Young Cho

Department of Plastic and Reconstructive Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.

Correspondence: Jae Young Cho. Department of Plastic and Reconstructive Surgery, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Nowon-gu, Seoul 01757, Korea. Tel: +82-2-950-1048, Fax: +82-2-932-6373, JYCHO@paik.ac.kr

Received 2016 April 02; Revised 2016 July 21; Accepted 2016 August 09.

Magnetic resonance imaging (MRI) is a safe and accurate radiologic tool [1]. However, there is also a risk of physical injury or thermal injury [1 2]. During MRI scanning, wearing monitoring equipment containing metal such as pulse oximetry and ECG monitoring leads can cause contact burns; a few cases of thermal injury during MRI scanning in unconscious patients have been reported [1 2]. However, no case has been reported in conscious and sensible patients during these situations.

In May 2015, a 57-year-old male patient came to the emergency department of our hospital for multiple trauma. While undergoing MRI examination for a cervical spine fracture with pulse oximetry (Fig. 1) on his left index finger, he suffered a third-degree contact burn on that finger (Fig. 2). After 2 weeks of dressing, a homodigital island flap operation was performed, and 2 months after the operation, the wound had completely healed and the finger had full range of motion (Fig. 3).

Fig. 1

Pulse oximetry. Pulse oximetry was applied on the left index finger of the patient.

Fig. 2

Third-degree contact burn. A third-degree contact burn occurred on the distal phalanx of the left index finger. Eschar formed on the site of the injury.

Fig. 3

Two months after the operation. At two-month follow-up, the surgical site had completely healed, with no limitation of motion.

In most cases of thermal burn induced by pulse oximetry during MRI, the patient has been sedated or in a nonverbal state [1 2]. Even to alerted patients with normal senses, such burns are caused by staff negligence. The most common is that patients still have the pulse oximetry that should be removed before MRI. The antenna effect between MRI and pulse oximetry comes into effect so instantly that full-thickness burn is already caused before patients recognizes and removes the pulse oximetry [3]. Extreme caution is required for removal of pulse oximetry before MRI examination.

Notes

No potential conflict of interest relevant to this article was reported.

References

1. Jones S, Jaffe W, Alvi R. Burns associated with electrocardiographic monitoring during magnetic resonance imaging. Burns 1996;22:420–421. 8840046.

2. Karoo RO, Whitaker IS, Garrido A, et al. Full-thickness burns following magnetic resonance imaging: a discussion of the dangers and safety suggestions. Plast Reconstr Surg 2004;114:1344–1345. 15457066.

3. Balanis CA. Antenna theory: analysis and design Hoboken: Wiley Interscience; 2005.

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Fig. 1

Pulse oximetry. Pulse oximetry was applied on the left index finger of the patient.

Fig. 2

Third-degree contact burn. A third-degree contact burn occurred on the distal phalanx of the left index finger. Eschar formed on the site of the injury.