Dermatology
Electrosurgery
Built from Dermatology, 5th Edition
What’s inside
10 sections · 62 slides
Overview
- Six things this topic covers
What Electrosurgery Is
How everyday alternating current becomes a tool that dries, seals, or cuts skin
- Electrosurgery in one sentence
- Electrocautery is not the same thing
- Electrocautery versus the electrosurgery currents
- Damped and undamped current waveforms
- Waveforms and their electrosurgical uses
- Monopolar versus bipolar electrodes
- Monoterminal versus biterminal circuits
- Electrosurgical unit and its two attachments
A Short History
From a lightning-inspired spark to Harvey Cushing's operating room in 1926
- Electrocautery: the ancient forerunner
- Building a safe high-frequency current
- Naming the modern techniques
- Milestones on the way to modern electrosurgery
- William Bovie and the modern era
Clinical Indications
Matching how deep a lesion sits to how deep the current should reach
- Three jobs an electrosurgery unit can do
- A quick reference table
- Common dermatologic indications for electrosurgery
Preoperative Preparation
Getting the room, the patient, and the equipment ready before switching on the current
- Patient history and safety checks
- Protecting the treatment team
- Skin preparation and fire risk
- Anesthesia before treatment
- Final equipment checks before starting
Electrosurgical Techniques
Three currents, three depths of damage: surface drying, deep coagulation, and cutting
- Electrodesiccation: drying the surface
- Electrofulguration: sparking at a distance
- Seborrheic keratosis treated by electrodesiccation
- Technique and treatment endpoint
- Electrocoagulation: a deeper, biterminal current
- Curettage and electrosurgery for skin cancer
- Curettage and electrosurgery for basal cell carcinoma
- Repeating the cycle to clear the tumor
- Using electrocoagulation to stop bleeding
- Fine-needle electrocoagulation of facial telangiectasias
- Electrosection: cutting with current
- Reading the power setting
- Electrosection versus scalpel surgery
- Rhinophyma treated by electrosurgical planing
- Where electrosection shines
Cardiac Implantable Electronic Devices
Precautions for patients with a pacemaker or implantable defibrillator
- Why cardiac devices need special care
- Four routine precautions
- Choosing the safest current for these patients
Postoperative Care and Complications
Wound care, and the hazards every electrosurgery patient and operator should know about
- Routine wound care after treatment
- Bleeding and scarring after treatment
- Four more hazards to know about
- Fire risk
- Thermoelectric (accidental) burns
- Microorganism transmission
- Surgical smoke: what is in the plume
- Controlling the smoke plume
Electroepilation and Iontophoresis
Two more everyday uses for electrical current: destroying hair roots, and calming sweat glands
- Electroepilation: permanent hair removal by current
- Electrolysis: a chemical reaction at the root
- Thermolysis: destroying hair with heat
- The 'blend' technique and comfort
- Regrowth, scarring, and other side effects
- Iontophoresis for excess sweating
Future Directions
Why an old technology is being reimagined for facial resurfacing and skin tightening
- A resurgence, thanks to the laser era
- New electrosurgical applications
- Key takeaways
- References
- References (continued)
- References (continued)
- References (continued)
- Dermatology, 5th Edition (2-Volume Set)