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Optimization of thermocautery in excisional dermatologic surgery
Joshua E Lane1, Edward M O'brien, David E Kent
1Division of Dermatology, Department of Internal Medicine, Mercer University School of Medicine, Macon, Georgia 31217, USA.
Summary
This study evaluated an adjustable thermocautery unit for surgical hemostasis. The device provides safe and effective heat-based bleeding control, crucial for patients with pacemakers.
Area of Science:
- Dermatology and Surgical Technology
Background:
- Electrosurgery is a standard hemostasis technique in cutaneous surgery.
- Thermocautery offers a safer alternative for patients with implantable cardiac devices, as it uses heat without electrical current.
- An adjustable, commercially available thermocautery unit's performance was assessed.
Purpose of the Study:
- To examine the temperatures and utility of a specific adjustable thermocautery unit.
- To determine the effectiveness and safety of thermocautery for hemostasis in cutaneous surgery.
Main Methods:
- Tip temperatures were measured using a type E thermocouple in air and tissue.
- Measurements were taken at various device settings (1-9 in air, 3-8 in tissue) for 20-30 second intervals.
- In vivo testing was conducted on surgical patients under IRB approval.
Main Results:
- In vitro testing showed predictable temperature increases from 350°C to 900°C with higher settings.
- In vivo testing revealed similar temperature ranges, with tissue contact reducing tip temperature by ~50%.
- A bloody surgical field further decreased the tip temperature.
Conclusions:
- The examined thermocautery unit is effective and safe for achieving surgical hemostasis.
- Adjustable temperature control (100°C-400°C) allows for optimal hemostasis, unlike fixed-temperature units.
- This method is suitable for patients requiring hemostasis and who have cardiac implantable devices.
