On flowing through tissues, radiofrequency current leads to intracellular conversion of electromagnetic energy to mechanical energy to thermal energy. The resultant heat causes the various tissue effects of electrosurgery. Table 2 shows the effect of temperature on cells and tissues. When the intracellular temperature rises rapidly to more than 100°C, cellular vaporisation with explosion occurs and leads to a cutting effect. A gradual increase in temperature of between 60°C and 95°C leads to simultaneous tissue desiccation and coagulation. Fulguration is non-contact sparking with the coagulation output to produce a superficial layer of black coagulation over a wide oozing surface. By contrast with cutting, fulguration uses high voltage with a low duty cycle of 6%. When electrical arcs hit the tissue, they produce high temperature and carbonisation; the temperature then returns towards normal during the long off-period of the duty cycle. This results in a thin layer of black coagulation that insulates deeper tissue and reduces lateral thermal spread. The high voltage of fulguration helps to overcome impedance of the intervening air between the active electrode and the tissue. This increases the risk of stray current burns in laparoscopic surgery.
Jinhua Huacheng Medical Appliance Co.,Ltd.
Manufactuer of disposable medical products: Electrosurgical pencil,grounding plate,skin stapler and ECG electrode
