Analysis of common types and causes of high-frequency electrocautery burns

一、What is the meaning of high-frequency electric knife burns

        High-frequency scalpel burns are burns and scalds that are formed when high-frequency scalpels break down and injure cells and tissues as a result of electrical energy during surgical procedures.

        High-frequency electric knife burns can cause surgery and treatment after the appearance of common scalding lesions seen in the naked eye, such as ulcers, bleeding, as well as burn lesions, the so-called burn lesions refers to the radiation particles or ionic air flow coking phenomenon caused by the death of tissue cells, often manifested in the skin and its shocked and muscle scarring neoplasms, neoplasms and dysfunction, and so on.

二、 The common types of high-frequency electric knife burns

High-frequency scalpel burns can be divided into two categories.

1, pole plate burns

When the pole plate at the contact area with the patient's skin is too small (less than 64.5cm) local contact impedance is too large, the pole plate at the irrigation fluid mannitol liquid wet, will make the pole plate and the patient's body adhesion is reduced, with some topical medicinal water rinsing, and sometimes will not be noticed or the pole plate at the hair is too much, easy to cause electrode plate at the current density of the electrode plate is too large and caused by the pole plate burns.

2, non-plate burns

The pole plate and the cutter head and its connecting cable and the patient's body constitute the electro-knife circuit system, when the electro-knife circuit system is not used properly, even if the pole plate is well placed during the operation, the patient is still at risk of burns, mainly in the following cases.

(1) Ground shunt

The patient's skin is equivalent to a resistor, the resistive load distribution of this resistor countless different potential points, especially in the surgical current through the region, the potential difference is particularly large in two or more points once the short circuit, will form an abnormal channel of high-frequency currents, that is, the so-called “grounding shunt” phenomenon, at this time, the patient's body of the small grounding point due to the circulation of high-frequency high-frequency currents may occur burns. Burns may occur. For example, if the patient is exposed to directly grounded metal and equipment (such as surgical beds and stents), scalpel burns are likely to occur.

(2) high-frequency radiation

The patient carries a metal object is not grounded, but for the use of high-frequency scalpel, this metal body is tantamount to a transmitting antenna, outward emission of energy, if the emission of energy is large, the contact point is small, then the high-density electric frequency will produce burns at the contact point. Such as when the patient wears metal jewelry or installed metal prosthesis, etc., also prone to electric knife burns.

(3) Sparks low frequency

When the pole plate and the knife head in the connection part of the failure, the connection point or cable breakage caused by sparking and produce low-frequency current. This low-frequency current is extremely harmful to the patient's low-frequency burns not only occur on the body surface, may also occur in the body at the same time, the patient may at any time produce a more serious tremor phenomenon or even cause ventricular fibrillation, which should be given sufficient attention.

三、What are the causes of high-frequency electric knife burns

There are many possible causes of high-frequency scalpel burns, mainly.

1, electrical energy conversion exists in the efficiency is not high

High-frequency scalpel burns mainly from the decomposition of electrical energy, the operator needs to convert electrical energy into thermal energy for surgical use, but due to the inefficiency of electrical energy in the conversion process, prone to loss of electrical energy, these losses of electrical energy will damage the cells in the surgical process, thus causing high-frequency scalpel burns.

2, the inadequacy of conventional surgical preparation

Often the operator fails to properly understand the scope of surgical operation, operation steps, operation points before the operation, fails to correctly select the surgical instruments, operation parameters are set incorrectly, fumigation disinfection operation failed to properly take into account the huge difference between the patients, fails to correctly use high-frequency scalpel, fails to correctly select iodine oil drops and point anesthetic, as well as fails to correctly deal with and clean up all kinds of wastes after the high-frequency scalpel, etc.. These improper operations can cause overheating of the HF scalpel, which can lead to excessive burns on the patient's skin and epidermis and bring side effects to the patient.

3, improper operation in surgery

After the use of high-frequency scalpel, the operator fails to turn on the thermal control system of surgery early, fails to remove the surface heat of the surgical instrument connection in time, fails to change the position of the electric heater in the surgery in time, as well as other common improper operation, these behaviors will make the temperature of the high-frequency scalpel to be altered, which will cause the patient's epidermis and tissue cells to suffer from deep burns.

4, improper use of surgical instruments during surgery

During surgery, the operator often uses broken and contaminated surgical instruments, so that they lose their original function and quality, thus making the surgical instruments lose good conductive properties, so that the high-frequency electric knife can not pass the electrical energy, thus causing tissue cells to be burned, causing high-frequency electric knife burns.

5, high-frequency scalpel and other related surgical instruments quality problems

The quality of high-frequency electrosurgical knife and other related surgical instruments is sometimes unsatisfactory. Their quality is not tested by the factory, the components are unqualified, the materials are of low quality, and the conductivity is poor, which leads to the failure of the internal design principle and the low efficiency of the conversion of electric energy. When these surgical instruments are used, the decomposition of high-energy electric energy will be caused, which will result in the burns caused by high-frequency electrosurgical knife.