Multi-component plasma fluid approach to sparking enhanced burns as a complication of diathermy
Keywords:Burns, Diathermy, Multi-component fluid model, Tissue
Background: The effects of electric currents flowing through a human body vary from no perceptible to severe tissue injury caused by the electrosurgical spark. Although modern electrodes have been designed to minimize this complication, it was reported that burns have accounted for 70% of the injuries during electro surgery. Some risks of complications depend on a surgeon's knowledge of instruments and safety aspects of technical equipment. The use of alcohol and spirit-based skin preparation solutions brings another risk of burn injuries.
Methods: Apart from the experimental methods, computer modelling is shown to be an effective approach to improve the performance of electrosurgical procedure. The benefits of simulation assisted electro surgery include no ethical approval, low cost, safe and the most important removing conditions that may lead to tissue burns. Here, the onset of sparking between the electrosurgical electrodes has been studied by using the multi-component plasma fluid model.
Results: It was found that the electrode shape significantly affects the sparking formation. The minimum voltage required for sparking has been achieved for cylinder-cylinder configuration, while for other arrangements breakdown voltages are higher. Electrical sparks do not occur equally in both directions between active and passive electrodes due to electrical asymmetries.
Conclusions: This study is dealing with application of multi-component plasma fluid model in simulating sparks produced between electrosurgical electrodes of various shapes, materials and dimensions. Our simulation model offers substantially greater physical fidelity as compared to simulators that use simple geometry. The obtained results are applicable for prevention of potential complications during diathermy procedure.
Boyd DE, Palmer JHM. Surgical diathermy. Anaesthesia & Intensive Care Medicine. 2013;14(10):P431-3.
MacG Palmer JH. Surgical diathermy and electrical hazards: causes and prevention. Anaesthesia & Intensive Care Medicine. 2016;17(10):P480-85.
Fu T, Lineaweaver WC, Zhang F, Zhang J. Role of shortwave and microwave diathermy in peripheral neuropathy. J Int Med Resea. 2019;47(8):3569-79.
Vedovato JW, Polvora VP, Leonardi DF. Burns as a Complication of the Use of Diathermy. J Bur Care Rehabilit. 2004;25(1):120-3.
Dewey WS, Cunningham KB, Shingleton SK, Pruskowski KA, Welsh AM, Rizzo JA. T2 Safety of Early Post-operative Range of Motion in Burn Patients with Newly Placed Hand Autografts. J Bur Care Rese. 2020;41(4):809-13.
McQuail PM, McCartney BS, Baker JF, Kenny P. Diathermy awareness among surgeons-An analysis in Ireland. Annals Med Surg. 2016;12(12):54-9.
Gibs P. Diathermy burns in the mouth. Two case reports. Austr Dent J. 1985;30(4):296-7.
Aigner N, Fialka C, Fritz A, Wruhs O, Zöch G. Complications in the use of diathermy. Burns 1997;23(3):256-64.
Demircin S, Aslan F, Karagoz YM, Atilgan M. Medicolegal aspects of surgical diathermy burns: a case report and review of the literature. Rom J Leg Med. 2013;21(3):173-6.
Tammam AE, Ahmed HH, Abdella AH, Taha SAM. Comparative Study between Monopolar Electrodes and Bipolar Electrodes in Hysteroscopic Surgery. J Clin Diagn Res. 2015;9(11):QC11.
COMSOL Multiphysics. Stockholm, Sweden; 2008. Available at: www.comsol.com. Accessed on 5 May 2020.
Radmilović-Radjenović M, Radjenović D, Radjenović B. Simulation studies of the electrode configuration effect on the breakdown phenomenon. Int J Advan Resea. Comp Sci Electro Engine. 2019;8(12):68-71.
Elshafieya O, Haroon M, Lotfi MA, Moghavvemi M. The Development of Spinal Surgery Training Model. AIP Confer Proceed. 2019;2102:130009.
Meek JM, Craggs JD. Electrical breakdown of gases. Oxford, UK: Oxfo Pre;1953.
Dias E, Schneider B, Ribeiro E. On the origin of skin burns and neuromuscular electrical stimulation as a consequence of electrosurgical procedures. Resea Biomed Enginee. 2019;35(2):111-22.
Dodde RE, Gee JS, Geiger JD, Shih AJ. Monopolar Electrosurgical Thermal Management for Minimizing Tissue Damage. IEEE Transac Biomed Enginee. 2012;59(1):167-73.
Lu Z, Arikatla VS, Han Z, Allen BF, De S. A Physics-based Algorithm for Real-time Simulation of Electrosurgery Procedures in Minimally Invasive Surgery. Int J Med Robot Comp Assis Surg. 2014;10:495-504.
Radmilović-Radjenović M, Radjenović B. Studies of the origin of skin burns during electrocautery based on multi-component plasma fluid model. J Surg Surgic Rese. 2020;6(1):27-9.
Brown DB. Concepts, considerations, and concerns on the cutting edge of radiofrequency ablation. J. Vasc. Interventional Radiol. 2005;16:597-613.
Massarweh NN, Cosgriff N, Slakey DP. Electro surgery: History, principles, and current and future uses. J Amer Colle Surge. 2006;202:520-30.