Electrosurgery (Tables 6-9 , 6-10) - Use of high-frequency alternating current to create thermal tissue destruction (includes electrosection, electrocoagulation, electrofulguration, electrodesiccation)
- Electrocautery often mistakenly interchanged with the term electrosurgery
- Electrocautery involves direct current producing thermal energy (tissue in contact with heated wire)
- No current passing through patient
- Safe for patients with pacemakers
- Forms of electrosurgery
- Electrocoagulation: lower voltage, higher amperage; bipolar current thermally damages relatively deep tissue with ↑ tissue coagulation
- Electrosection: lower voltage, higher amperage; current penetrates deeper with ↑ tissue coagulation; minimal peripheral heat damage to surrounding tissue
- Electrofulguration: electrode held away from tissue, electrical spark crosses gap between tissue/electrode and burns tissue superficially; high voltage, lower amperage
- Electrodesiccation: electrode touches tissue causing superficial tissue dehydration (desiccation); ↓ heat compared to electrosection; high voltage, low amperage; low energy limits tissue damage; best for superficial, avascular lesions (seborrheic keratosis)
| | | | | | | Table 6-9 Types of Electrosurgery | | | Type of procedure | | Voltage | | Amperage | | Skin contact w/ electrode | | Circuit | | | Electrosection | | ↓ | | ↑ | | Y | | Biterminal | | | Electrocoagulation | | ↓ | | ↑ | | Y | | Biterminal | | | Electrofulguration | | ↑ | | ↓ | | N | | Monoterminal | | | Electrodesiccation | | ↑ | | ↓ | | Y | | Monoterminal | | | | | | | | | | | |
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| | | | | | | Table 6-10 Electrosurgical Terminology | | | Terms | | Description | | | 1. Monopolar/Bipolar | | Misnomer since treatment electrodes without true positive/negative poles; instead, the terms monoterminal and biterminal should be used | | | 2. Monoterminal | | Only one electrode used to deliver current to the patient | | | 3. Biterminal | | Two electrodes used to deliver current to patient; current flows from one electrode to the other to complete an electrical circuit | | | | | |
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