Electrosurgery: High‐Frequency Modalities

Abstract

The most popular form of electrosurgery used in cutaneous surgery involves the application of high voltage electromagnetic energy in the form of a damped sine wave. This form of current may be applied by electrofulguration, electrodesiccation, or electrocoagulation. The principles involved in the application of these three forms of electrosurgery are discussed.

Application of Argon Plasma Coagulation in Skin Surgery

“…However, up to now no reports exist on the application of APC in the treatment of skin disorders. This is surprising, since the demonstrated properties of this method make it likely that APC is able to compete with other already established dermatological treatments such as standard electrocoagulation [1, 2, 3, 4]and CO 2 laser therapy [5, 6, 7, 8, 9]. Similar to these two techniques APC is simple and quick to perform, and represents an ambulatory office procedure requiring only local anesthesia and no multiple office visits for dressing changes or suture removal.…”

“…In dermatological practice, classic electrocoagulation [1, 2, 3, 4]and CO 2 laser therapy [5, 6, 7, 8, 9]are two often used treatment modalities. However, both methods have certain disadvantages.…”

Radiofrequency ablation and plication of hemorrhoids

“…Addition of radiofrequency ablation of the pile mass doubly ensured complete blockage of blood supply to the pile mass [21]. This technique could also deal with secondary piles found on occasion at 1, 5, and 9 o'clock positions through a direct coagulation [22].…”

Electrosurgery, Electrocoagulation, Electrofulguration, Electrodesiccation, Electrosection, Electrocautery

“…Continuous wavetrains result in greater tissue heating because the current flows for a longer period of time. 2,9 Spark-gap units produce damped waveforms because the resistance offered by the spark-gap causes successive wave amplitudes to gradually decrease to zero. Vacuum-tube units, by contrast, produce undamped waveforms because the thermionic tube neutralizes the internal resistance within the circuit, and allows the waveform to continue unchanged (see Fig.…”

“…As they profoundly influence the quality and extent of tissue injury, intelligent use of such electrical concepts as current density, resistance, voltage, power and waveform output may optimize therapy and minimize adverse events during electrosurgery. 4,7,9 ■ PREOPERATIVE PREPARATION Preoperative care should attempt to minimize risks specific to electrosurgery. History and physical examination should characterize risk factors for excessive blood loss, such as bleeding diathesis, or poor healing, such as vasculopathy, malnutrition, diabetes mellitus, or poor general medical condition.…”