Limitations
Monopolar diathermy in use intra-operatively
In monopolar mode, good contact between the patient and the ground plate is essential. If this surface area is decreased, for example if the ground plate slips partially off the patient, then this can result in severe burns. Fortunately, many modern machines monitor impedance and will stop working if this occurs.
The ground plate should be positioned as close to the operative site as possible, however it should not be placed over a bony prominence, metal prosthesis, distal to a tourniquet, over scar tissue, on hairy surfaces, or on pressure points, to minimise the risk of burns. The plate should also be kept dry.
There is also the theoretical risk of smoke and contaminant inhalation when using diathermy, to both surgeon and theatre staff, hence appropriate masks should be used in well ventilated areas.
Contraindications
Implantable devices such as pacemakers and spinal cord stimulators are at risk of damage from the electrical current in diathermy. This can lead to failure of the device, however this risk is reduced with the use of bipolar (instead of monopolar).
In-situ defibrillators can also interpret the diathermy current as VF and potentially lead to shocking the patient. Consequently, such devices need to be deactivated prior to surgery.
Jinhua Huacheng Medical Appliance Co.,Ltd.
Manufactuer of disposable medical products: Electrosurgical pencil,grounding plate,skin stapler and ECG electrode
