Monopolar Coagulation; Contraindications And Collateral Effects - Carlo De Giorgi SURGERY PLUS Manual De Instrucciones

bone, but since good coagulation while cutting is one of principal benefits of using electro
surgery a current with a certain amount of modulation is desirable.
The following rules help the operator to obtain good cutting, however every user must
follow first of all his professional judgment as he does every time in his practice.
●
Keep the tissues moist but not wet;
●
Survey the stroke before activate the electrode;
●
Keep the electrode perpendicular to the tissue;
●
Activate the electrode before making contact with the tissue
●
Maintain clean the electrode's tip (the optional sponges F7520 to clean the elec-
trodes are advised);
●
Wait at least five seconds before to repeat a stroke.
When the output power is properly set there should be:
●
no resistance to the electrode movement through the tissue;
●
no change in the cut surfaces color;
●
no fibers of tissue remained onto the electrode.
Monopolar Coagulation
Monopolar coagulation is the haemostasis of small blood vessel of the bodily tissue
through passing of high frequency current in correspondence of active electrode. When
the current density is reduced and a broad-surfaced electrode is used, to dissipate the
energy over a larger area, the effect is to dry out the surface cells, without deep penetra-
tion, resulting in coagulation. These coagulate surface cells then serve as a layer of in-
sulation, preventing heat derived by successive applications of current from penetrating
too deeply. The current normally used for coagulation is modulated and depending from
the modulation percentage is the smoothness of cutting, goodness of haemostasis and
likelihood of tissue destruction. Deeper current modulation brings to somewhat roughly
cutting and the chance of some slight depth of tissue destruction but more efficient co-
agulation.
The following rules help the operator to obtain good coagulation: however every user
must follow first of all his professional judgment as he does every time in his practice:
●
Select a ball or heavy wire electrode;
●
Locate the bleeder, after have wiped the excess blood from the area, contact
lightly the bleeder before activating the electrode;
●
Stop the electrode activation as soon as the tissue blanches to avoid tissue
damage;
●
Maintain clean the electrode's tip (the optional sponges F7520 to clean the elec-
trodes are advised).
CONTRAINDICATIONS AND COLLATERAL EFFECTS
Electro surgery is not recommended in the following subjects:
●
having pacemaker;
●
with stimulating electrodes;
●
with metal prosthesis plant;
●
with important arterial pressure unbalance;
●
with important nervous disorders;
●
with renal insufficiency;
●
in state of pregnancy.
Burns are the most consequences of the HF electro surgery for the patient, even if these
are not the only one. In fact necrosis by compression, allergic reactions to the disinfec-
tant, gas or inflammable liquids ignition.
Some important causes of burns are by:
●
insufficient medical equipe training about all modalities to avoid or reduce the
risks of burns by using HF electrosurgical units;
●
use of disinfectants with high alcol content;
●
incorrect position of the patient during the electrosurgical operation;
●
contact between active electrode and the skin
●
contact with liquid;
●
long application of HF currents;
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