The Use Of High Frequency Electrosurgical Unit

High-frequency electrosurgical  unit is a kind of electrosurgical equipment which replaces mechanical scalpel for tissue cutting. It heats and vaporizes the tissue when it contacts the body with the high-frequency and high-voltage current generated by the effective electrode tip to realize the separation and solidification of the body tissue, so as to achieve the purpose of cutting and hemostasis.

The operation mode of high-frequency electrosurgical is divided into two types, namely monopole mode and bipolar mode:

A. In the monopole mode, it is necessary to paste a negative plate. The current passes through the active wire and electrode to the surgical site, and then the negative plate and its wire are returned to the main machine of the high-frequency electroknife. A complete circuit is used to cut and solidify the tissue.

b. In bipolar mode, bipolar electrocoagulation provides high-frequency electrical energy to body tissues through the two tips of bipolar tweezers to dehydrate and coagulate the blood vessels between the two ends of the bipolar to achieve the purpose of hemostasis. Its scope of action is limited to the tweezers between the two ends, the degree of damage to the body tissue and the scope of influence is much smaller than the unipolar way, and it is also suitable for the closure of small blood vessels (diameter < 4mm) and fallopian tube. Therefore, bipolar electrocoagulation is mainly used in brain surgery, microsurgery, ent department, obstetrics and gynecology, hand surgery and other delicate operations. The safety of bipolar electrocoagulation is gradually recognized and its application scope is gradually expanded.

Operating procedure for safe use of electric knives

1. Choose high-frequency electric knife without fan natural cooling system (suitable for most laminar flow purification operating rooms). Evaluate whether the patient is suitable for the use of electric knife, select the appropriate brand of surgical accessories according to the operation, and check whether the power supply and electrode cables are broken and metal wires are exposed

2, select and check the negative plate, check the wire and chuck; Choose the right size and shape of the negative plate (15KG infants should choose special plates for infants), check the adhesion of the conductive plate. 

3. Assess the patient's skin, select the appropriate site to install the negative plate and connect the negative plate plug to the machine

A, suitable installation site: flat vascular rich muscle area as close as possible to the surgical site (but not less than 15CM); Local skin hair removal and keep dry and clean; And the surgical site can not be left or right cross; Metal implants, pacemakers and ECG monitoring electrodes are not allowed in the current loop.

B. Inappropriate parts for installation: skin folds and bone ridges, scars, thick fat, weight-bearing parts of the body, and fluid accumulation parts.

C, pay attention to the installation of negative plate: check the expiration date, if the product is expired or unsafe suspicion, do not use; If double-chip is used, the central axis of the dual-chip neutral electrode should always be positioned toward the surgical area. Plate and skin should be closely connected; Keep the plate flat and can not be cut or folded; Avoid wetting the plate when disinfecting and rinsing.

4. Connect the electric knife and pen to the machine, start up the self-test, show that the plate is installed correctly without alarm indication, adjust the output power.

5, after use, correctly shut down and remove the negative plate, check the skin below the plate, and clean the repeatedly used electric knife and pen with wiping method (do not use blister washing).

Techniques for removing the negative plate: fix the skin, slowly remove the whole piece along the long axis of the skin and the horizontal direction of the texture, do not pull the plate chuck to remove.

Precautions during use

1. Avoid bypass burns: the patient's limbs should be wrapped with cloth and properly fixed. Skin-to-skin contact (such as between the patient's arms and body) should be avoided. Contact with grounded metal should not be kept.

2, avoid equipment leakage or short circuit: do not wind the wire on the metal articles, there is a ground wire device to connect.

3. The output power should be limited to just ensure the surgical effect. Do not blindly increase the output power of the electric knife. Because all kinds of risks in high-frequency electrosurgical operation will increase with the increase of power. When the power required by the operation is significantly greater than the normal value (the power used in monopole electrosurgical operation is about 10-80W in general, and the power required in special operations such as amputation is larger, but rarely exceeds 200W), the placement of the plate, the integrity of the plate and the cable of the cutter head, the state of the machine and the degree of suspension of the patient should be checked. Do not arbitrarily increase the output power set value. When the normal power cannot be predicted, it should be tested gradually from small to large until it is just enough.

4. The contact area of the negative plate was checked again for displacement after the patient moved.

5. Avoid accidental injury caused by improper operation

① Keep the surgical towel dry

② The electric knife and pen should be put in the insulated container when not in use

③Try to use direct electric coagulation and hemostasis method, prohibit the noise suppression of the alarm system, when there is abnormal sound, the use should be stopped immediately and the cause should be checked

Post time: Nov-08-2022