Dispersive pad site burns with modern radiofrequency ablation equipment

Pad burns during or after radiofrequency ablation (RFA) are a skin complication probably underreported in the literature. We report on 4 severe pad burns, deep second and third degree, in 3 patients undergoing radiofrequency ablation of liver malignancies, 1 percutaneously and the other 2 after laparotomy. All burns occurred at the leading edge or at the corner of the pads attached to the patients' thighs. Potential causes leading to the burns are discussed. Current dispersive pad designs do not prevent the leading edge phenomenon and subsequent burns. Further developmental work in the pad design with the possibility of skin temperature monitoring via temperature sensors under the leading pad edge is needed.