Heat-Related Complications from Radiofrequency and Electrocautery Devices Used in Arthroscopic Surgery: A Systematic Review

Eck, Carola F. van; Meel, Tim A.C. van; Bekerom, Michel P.J. van den; Zijl, Jacco A. C.; Kooistra, Bauke W

doi:10.1016/j.asmr.2020.12.002

Cited by 11 publications

(3 citation statements)

References 49 publications

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“…In orthopaedic surgery, most of the reported cases occurred during arthroscopic surgery procedures. Reported cases in open surgery are rarer [12][13][14]. In the present case, it is likely that the injuries were caused by direct coupling when the active electrode inadvertently encountered a non-insulated metallic instrument such as an orthopaedic retractor.…”

Section: Discussionmentioning

confidence: 81%

Implementation of an Electrosurgical Checklist in a Podiatry Unit in Relation to a Case of Inadvertent Burns during Hallux Valgus Surgery

Córdoba-Fernández,

Jiménez-Cristino,

Mármol-García

et al. 2023

Reports

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Iatrogenic burns are unpleasant and sometimes difficult to explain to patients. Podiatric surgeons routinely use electrosurgical devices to cut and coagulate tissue during surgical procedures. Although advances in technology have made electrosurgery increasingly safer for patients and personnel, its use is still poorly understood by the surgical community, and the hazards associated with its use still exist presently. Human error, direct or indirect transfer of electricity to a conductive device, or device malfunction can cause serious adverse events, including burns, electrical shocks, and or fires. Here, we report a rare case of a 43-year-old man who suffered severe burns during hallux valgus surgery. The surgeon and the nursing staff did not notice any injuries during the surgical intervention. This unusual clinical case serves to highlight the importance of implementing protocols to prevent injuries related to the use of electrosurgery. Based on this report, a specific checklist was implemented to prevent adverse events related to electrosurgery in our podiatric surgery unit to reduce the risk of electrosurgical complications. The implementation of the checklist can be useful to help health professionals improve patient safety during surgery and avoid potential medico–legal liability claims.

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Section: Discussionmentioning

confidence: 81%

Implementation of an Electrosurgical Checklist in a Podiatry Unit in Relation to a Case of Inadvertent Burns during Hallux Valgus Surgery

Córdoba-Fernández,

Jiménez-Cristino,

Mármol-García

et al. 2023

Reports

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“…However, the continuous use of these devices can lead to thermal tissue damage. 11,20 Despite a lack of studies investigating whether the incidence of thermal damage decreases with reduced electrocautery device usage, it is hypothesized that intermittent device use can mitigate such risks. In line with widely acknowledged guidelines, our institution recommends limiting continuous usage to no more than 3 seconds to minimize thermal damage 21,22 Likewise, the use of the electrocautery device may also differ depending on the surgical environment or user.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of tranexamic acid for improving visual clarity by reducing total coagulation time during arthroscopic rotator cuff repair

Lim,

Do,

Chang

et al. 2023

Preprint

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This study aimed to investigate the reliability of electrocautery sound spectrogram visualization and to examine the effectiveness of tranexamic acid during arthroscopic rotator cuff repair in terms of coagulation and operation time. We included 132 patients who underwent arthroscopic rotator cuff repair using the double-row suture bridge for medium-sized full-thickness rotator cuff tear with 1g IV tranexamic acid or without tranexamic acid. During surgery, the sound of the electrocautery device was recorded, and the total coagulation time was analyzed using a spectrogram. The primary outcome was total coagulation time. The total coagulation time was significantly reduced in the study group compared to the control group. Spectrographic analysis of sounds produced by electrocautery devices is reliable for measuring coagulation time during arthroscopic surgery. Use of tranexamic acid may provide better visual clarity during arthroscopic cuff repair by reducing coagulation time with an electrocautery device.

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“…However, it can still generate intense temperatures with notable potential for injury. Van Eck et al 28 noted a variety of types of heat-related injuries, including dermal burns from leakage of overheated arthroscopy fluid and chondrolysis, and in approximately 25% of cases, RF devices were the only identifiable cause.…”

Section: Electrical Sourcesmentioning

confidence: 99%

Thermal Damage in Orthopaedics

Rowland,

Raji,

Nelles

et al. 2024

J Am Acad Orthop Surg

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There are numerous potential sources of thermal damage encountered in orthopaedic surgery. An understanding of the preclinical mechanisms of thermal damage in tissues is necessary to minimize iatrogenic injuries and use these mechanisms therapeutically. Heat generation is a phenomenon that can be used to a surgeon's benefit, most commonly for hemostasis and local control of tumors. It is simultaneously one of the most dangerous by-products of orthopaedic techniques as a result of burring, drilling, cementation, and electrocautery and can severely damage tissues if used improperly. Similarly, cooling can be used to a surgeon's advantage in some orthopaedic subspecialties, but the potential for harm to tissues is also great. Understanding the potential of a given technique to rapidly alter local temperature—and the range of temperatures tolerated by a given tissue—is imperative to harness the power of heat and cold. In all subspecialties of orthopaedic surgery, thermal damage is a relevant topic that represents a direct connection between preclinical and clinical practice.

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Heat-Related Complications from Radiofrequency and Electrocautery Devices Used in Arthroscopic Surgery: A Systematic Review

Cited by 11 publications

References 49 publications

Implementation of an Electrosurgical Checklist in a Podiatry Unit in Relation to a Case of Inadvertent Burns during Hallux Valgus Surgery

Implementation of an Electrosurgical Checklist in a Podiatry Unit in Relation to a Case of Inadvertent Burns during Hallux Valgus Surgery

Effectiveness of tranexamic acid for improving visual clarity by reducing total coagulation time during arthroscopic rotator cuff repair

Thermal Damage in Orthopaedics

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