Pacemakers, Deep Brain Stimulators, Cochlear Implants, and Nerve Stimulators: A Review of Common Devices Encountered in the Dermatologic Surgery Patient

Tripathi, Shivani; Hurst, Eva A.

doi:10.1097/dss.0000000000002012

Cited by 6 publications

(5 citation statements)

References 48 publications

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“…There was a lack of compliance in obtaining a cardiology consult, and in deactivating the device before the procedure, which may be because of impracticality, and the relatively low complication rate with electrosurgery in the dermatologic setting. Given 43.48% and 32.17% of respondents routinely used heat electrocautery for ICD and PM, respectively, additional precautions would not be warranted, [1][2][3][4] which may explain these lower compliance rates.…”

Section: Discussionmentioning

confidence: 99%

“…Several literature reviews exist to aid in the management of electrosurgery with nerve stimulators. 2,3 There is consensus that deactivation of VNS before surgery is not necessary. For SCS, the device can be safely turned off before electrosurgery, which was only done 7.83% of the time in our study.…”

Section: Discussionmentioning

confidence: 99%

“…1 There are no currently available evidence-based guidelines that address the dermatologic surgical perioperative management in patients with IEDs. [2][3][4] Our study sought to investigate periprocedural electrosurgery screening and management and to quantify and qualify adverse events encountered with IEDs.…”

mentioning

confidence: 99%

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Electrosurgery and Implantable Devices: A Survey of Dermatologic Surgeons

2020

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Electrosurgery and Implantable Devices: A Survey of Dermatologic Surgeons

2020

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“…Bipolar instruments may be used in this area, though should not be used within 2 cm of the electrodes. 20,21 It is practical to identify the device model and contact the representative before surgery, have the patient remove the external implant in the preoperative holding area, and avoid the use of monopolar instruments on the head or neck, where a bipolar should be used instead.…”

Section: Cochlear Implantsmentioning

confidence: 99%

Perioperative Management of Nonorthopaedic Devices in the Pediatric Neuromuscular Patient Population

Tetreault

Illingworth

Oetgen

et al. 2023

J Am Acad Orthop Surg

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Pediatric patients with neuromuscular conditions often have nonorthopaedic implants that can pose a challenge for MRI acquisition and surgical planning. Treating physicians often find themselves in the position of navigating between seemingly overly risk-averse manufacturer's guidelines and an individual patient's benefits of an MRI or surgery. Most nonorthopaedic implants are compatible with MRI under specific conditions, though often require reprogramming or interrogation before and/or after the scan. For surgical procedures, the use of electrosurgical instrumentation poses a risk of electromagnetic interference and implants are thus often programmed or turned off for the procedures. Special considerations are needed for these patients to prevent device damage or malfunction, which can pose additional risk to the patient. Additional planning before surgery is necessary to ensure appropriate equipment, and staff are available to ensure patient safety. Patients with neuromuscular disorders often require surgical treatment to improve function, manage contractures, and correct deformity. Owing to underlying diagnoses or associated medical conditions, these patients may have medical implants to help manage muscle tone, control seizures, treat cardiac conditions, improve hearing, etc. Managing nonorthopaedic implants can cause delays and confusion when planning for advanced imaging studies and/or surgical intervention. Identifying these devices before MRI acquisition or surgical procedures is important to ensure the appropriate equipment, or support staff are available to maintain patient safety and device integrity.There is little guidance regarding the management of these implants, and manufacturer's recommendations may differ from practical application. Manufacturers' guidelines often make conservative recommendations accounting for rare worst case scenarios, but strict compliance to these guidelines may be impractical and could prevent medically necessary imaging or surgery for a patient. Treating physicians must navigate the conflict of risk-averse guidelines and patient's medical needs. Often, we rely on expert

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“… 28 The discussion with the assistant cardiologist is important since some cardiac devices can be temporarily turned off with a magnet. 31 Another possibility in some cases is the use of disposable electrocautery.…”

Section: Preoperative Considerationsmentioning

confidence: 99%

Mohs micrographic surgery: a review of indications, technique, outcomes, and considerations

Bittner

Cerci

Kubo³

et al. 2021

Anais Brasileiros de Dermatologia

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Mohs micrographic surgery is a specialized form of skin cancer surgery that has the highest cure rates for several cutaneous malignancies. Certain skin cancers can have small extensions or “roots” that may be missed if an excised tumor is serially cross-sectioned in a “bread-loaf” fashion, commonly performed on excision specimens. The method of Mohs micrographic surgery is unique in that the dermatologist (Mohs surgeon) acts as both surgeon and pathologist, from the preoperative considerations until the reconstruction. Since Dr. Mohs’s initial work in the 1930s, the practice of Mohs micrographic surgery has become increasingly widespread among the dermatologic surgery community worldwide and is considered the treatment of choice for many common and uncommon cutaneous neoplasms. Mohs micrographic surgery spares the maximal amount of normal tissue and is a safe procedure with very few complications, most of them managed by Mohs surgeons in their offices. Mohs micrographic surgery is the standard of care for high risks basal cell carcinomas and cutaneous squamous cell carcinoma and is commonly and increasingly used for melanoma and other rare tumors with superior cure rates. This review better familiarizes the dermatologists with the technique, explains the difference between Mohs micrographic surgery and wide local excision, and discusses its main indications.

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Pacemakers, Deep Brain Stimulators, Cochlear Implants, and Nerve Stimulators: A Review of Common Devices Encountered in the Dermatologic Surgery Patient

Cited by 6 publications

References 48 publications

Electrosurgery and Implantable Devices: A Survey of Dermatologic Surgeons

Electrosurgery and Implantable Devices: A Survey of Dermatologic Surgeons

Perioperative Management of Nonorthopaedic Devices in the Pediatric Neuromuscular Patient Population

Mohs micrographic surgery: a review of indications, technique, outcomes, and considerations

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