Electrosurgery

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SAMPLE EXCERPT
- Full procedure text, video and illustrations available with the full product
PRE-PROCEDURE
INDICATIONS
  • Patient desire to remove moles, telangiectasias (facial), and spider veins.
CONTRAINDICATIONS
  • Cardiac pacemakers (relative contraindication)
  • Uncooperative patient
EQUIPMENT
  • Alcohol wipe
  • Local anesthetic (e.g., 2% Xylocaine with or without epinephrine)
  • 1-mL syringe with 30-gauge needle
  • Electrosurgical unit (ESU)
  • Electrode tips (depending on procedure performed): Reusable or disposable
  • Antenna (or grounding) plate
  • Handpiece for tips (unit can be finger activated from this handpiece if desired)
  • Foot pedal to activate handpiece; foot pedal preferred for delicate surgeries
  • Smoke evacuator (HIV and HPV have been found in smoke plume)
  • Room air purifier or exhaust fan (removes residual odor)
  • Movable cart to hold the ESU, smoker evacuator, and equipment
  • Mask
  • Nonsterile gloves
  • Aluminum chloride (or Monsel's solution if the face is not involved)
  • Antibiotic ointment
  • Adhesive bandage

PROCEDURE
Sample excerpt does not include step-by-step text instructions for performing this procedure
The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

POST-PROCEDURE
CARE
  • No special wound care is needed.
COMPLICATIONS
  • Broken wire causing laceration (discard worn tips).
  • Too deep an excision, causing excessive scarring and trauma to undesired tissue.
  • Handpiece in wrong port or unit in wrong mode to obtain desired effect.
  • Pacemaker dysfunction.
  • Inadvertent burns resulting from unintended activation of handpiece.
  • Poor healing.
  • Pain, bleeding, and infection (extremely rare).
  • Scarring (could cause a skin depression, hypopigmentation, or hyperpigmentation).
  • Incomplete removal of a lesion.
  • Recurrence of the lesion.
  • Spread of infection between patients.
  • Sparks can cause explosions should alcohol or other agents be nearby.
  • Removal of a lesion from someone who is on aspirin or anticoagulant therapy may be accompanied by increased bleeding, necessitating heavier use of the coagulation waveform. However, do not discontinue warfarin, aspirin, or other anticoagulants.
  • Slowed or delayed healing may be seen in diabetic patients or in older patients with thin, poorly perfused skin.
  • Scarring action: Excising too deeply increases the likelihood of scars.
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