Early Detection of Monopolar Radiofrequency Tip Rupture Using Polarized Dermoscopy: A Preventive Approach Against...

Area of Science:

• Dermatology
• Medical Devices
• Radiofrequency Ablation

Background:

• Monopolar radiofrequency (MRF) devices utilize a capacitive membrane (CM) tip for uniform tissue heating.
• Peri-procedural CM rupture, though rare, poses a risk of thermoelectric burns.

Purpose of the Study:

• To assess if polarized dermoscopy and preventive strategies can detect CM ruptures early.
• To determine if these methods prevent burns during MRF treatments.

Main Methods:

• Retrospective review of MRF treatments with CM rupture events (2012-2024).
• Introduction of polarized dermoscopy and preventive measures (cryogen checking, shaving, patient education) in 2017.
• Clinical photograph assessment by dermatologists to identify thermoelectric burns.

Main Results:

• 8 of 8 patients (100%) experienced burns with naked-eye CM rupture detection (2012-2016).
• 0 of 5 patients experienced burns when using polarized dermoscopy for detection (2017 onwards), a statistically significant difference (p=0.0008).
• Preventive measures were associated with fewer CM rupture events (p=0.0063).

Conclusions:

• Polarized dermoscopy facilitates early detection of CM tip ruptures.
• Combined with preventive measures, it effectively prevents MRF-induced thermoelectric burns.