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To Remove or Not To Remove? Safety with Jewelry in Electrosurgery

12.13.2021 • Industry News

Image of Michelle Lemmons, Clinical Educator, OR
Michelle Lemmons, RN, BSN, PHN, CNOR, CCSVP
Clinical Educator, OR

“I have worn my wedding ring for 50 years, why do I have to take it off for my surgery?” This is a commonly asked patient question that can leave perioperative, circulating nurses, surgeons, and anesthesia staff stumped. While this seems like a logical request, it can be tricky if a patient does not want to remove jewelry for sentimental reasons or self-identity reasons. Some of the most common jewelry removal requests lately are nose/belly button rings as well as rings/various piercings. So, why do patients have to remove jewelry as part of their surgery prep?

The short answer is safety. Wearing jewelry during surgery carries risks that include but are not limited to:

  • Loss of jewelry
  • Risk of surgical site infection
  • Skin trauma and irritation
  • Injuries related to jewelry catching on drapes/bed
  • Airway blockage/choking

Although these risks are all important to consider, one of the most common complications discussed in industry literature is the risk of patient burns in surgeries where electrosurgical instruments are used. Jewelry can create an unintended site, independent of the path created by the OR team, for electrical current to exit the patient’s body.

Electrosurgery is used in over 80% of surgeries and research reveals there is an opportunity for improved awareness, training, and application for OR professionals. Industry best practice supports that all patient jewelry should be removed before surgical procedure, especially if it is in the pathway between the surgical site and the dispersive pad. Sometimes placing tape over the jewelry is suggested, however, taping does not prevent the flow of electrical current through that site and the risk of burn still exists as it doesn’t provide the necessary insulation for burn prevention. 

Complications during surgery can quickly become emergencies, and OR staff are challenged to reduce risk wherever possible, including removing patient jewelry. Removing all jewelry before surgery is best practice and should be detailed in facility policy and communicated with the patient. Positive surgical outcomes and patient safety are always the goals and that means understanding, assessing, and removing risks however possible.