Search Results (8)

In sea turtles, soft tissue abscesses typically present with a solid, caseous consistency and respond poorly to pharmacological treatment. A hawksbill turtle (Eretmochelys imbricata) exhibited a chronic subcutaneous mass near the cloacal region that had persisted for three years. Histopathological examination confirmed the existence of an abscess composed of concentric necrotic layers and chronic inflammatory cell infiltration, with no detectable pathogens. The lesion was surgically excised under local anesthesia with a radiofrequency electrosurgical unit, minimizing bleeding and operation time. Postoperative management consisted of oral antibiotic administration to minimize handling stress. The turtle recovered uneventfully, with no complications or recurrence during the two-month follow-up period. This case highlights that chronic abscesses in sea turtles require surgical excision as the most effective therapeutic approach and provides practical insights for marine reptile medicine. Full article

Iatrogenic burns are unpleasant and sometimes difficult to explain to patients. Podiatric surgeons routinely use electrosurgical devices to cut and coagulate tissue during surgical procedures. Although advances in technology have made electrosurgery increasingly safer for patients and personnel, its use is still poorly understood by the surgical community, and the hazards associated with its use still exist presently. Human error, direct or indirect transfer of electricity to a conductive device, or device malfunction can cause serious adverse events, including burns, electrical shocks, and or fires. Here, we report a rare case of a 43-year-old man who suffered severe burns during hallux valgus surgery. The surgeon and the nursing staff did not notice any injuries during the surgical intervention. This unusual clinical case serves to highlight the importance of implementing protocols to prevent injuries related to the use of electrosurgery. Based on this report, a specific checklist was implemented to prevent adverse events related to electrosurgery in our podiatric surgery unit to reduce the risk of electrosurgical complications. The implementation of the checklist can be useful to help health professionals improve patient safety during surgery and avoid potential medico–legal liability claims. Full article

In 2019, the United States (US) Advisory Committee on Immunization Practices (ACIP) recommended that healthcare providers engage in shared clinical decision making for adults aged 27–45 who may benefit from HPV vaccination. However, it is difficult to assess these benefits as there is a lack of data on HPV burden on young and mid-adult women. This analysis estimates the incidence of conization and the burden associated with treating pre-cancerous states related to HPV with a loop electrosurgical excision procedure (LEEP) or a cold knife conization (CKC) among commercially insured women aged 18–45. This retrospective cohort study used the IBM MarketScan commercial claims encounter database for women aged 18–45 treated with conization. We assessed the annual incidence of conization (2016–2019) and adjusted the two-year health care costs post-conization using a multivariable Generalized Linear Model (GLM)—accounting for follow-up time and other characteristics—stratified by the age groups, namely 18–26 and 27–45. The inclusion criteria were met by 6735 women, with a mean age of 33.9 years (SD = 6.2). Conization incidence was lowest for women aged 18–26 (41/100,000 to 62/100,000 women-years) and highest for women aged 31–35 (243/100,000 to 269/100,000). The GLM-adjusted, all-cause healthcare costs per patient per year were USD 7279 and USD 9249 in the 18–26 and 27–45 age groups, respectively. The adjusted costs for disease-specific care were USD 3609 and USD 4557 for women ages 18–26 and 27–45, respectively. The burden of conization and the associated costs were significant, indicating a potential healthcare benefit of HPV vaccination among young and middle-aged women. Full article

For patients suffering from myofascial pain syndrome (MPS) affecting muscles of mastication, traditional trigger point therapy treatment regimens can prove inconvenient, due to the short duration of pain relief after each injection and expense of repeated visits which are often not covered by insurance. We present a case of a patient treated using an alternative technique that could develop into an additional modality for treating MPS patients who are refractory to conservative treatment. This technique involves identifying and marking the patient’s trigger points and surgically cauterizing each location using a Bovie electrosurgical unit. While traditional trigger point injection therapy for myofascial pain syndrome is a well-described technique with acceptable pain relief expected for a period of 8–12 weeks, this technique provided up to 24 months of adequate pain relief in a patient. While further studies are indicated before widespread adoption can be recommended, this patient’s response suggests that this technique may be useful in offering longer-term pain relief compared with trigger point injection therapy. Full article

Air cleanliness is a crucial factor in operating theatres (OTs), where the health of patients and staff must be preserved by controlling air contamination. Particular attention must be paid to ultrafine particles (UFPs) size range, generated for instance by electrosurgical instruments (ESTs). OT contamination is also affected by ventilation systems, medical staff and their gowning system, staff routines, instruments, etc. This comparative study is based on experimental measurements of airborne microbial contamination and UFPs carried out during real ongoing surgeries in two OTs equipped with upward displacement ventilation (UWD) and hybrid ventilation, with unidirectional airflow on the operating table and peripheral mixing (UDAF+Mixing) ventilation systems. Airborne contamination concentration at the exit grilles has been analyzed as function of four different surgical phases normally performed during an operation. Results highlight that airborne contamination is influenced by the activities carried out during the surgical phases. EST usage affects the contamination level more than staff size during operation observed. Colony forming unit (CFU) values in the protected area close to the patient’s wound are influenced more by the type of ventilation system than by surgical phases. CFU values decrease by 18 to 50 times from the UWD system to the hybrid one. The large airflow volumes supply together with high air velocities in OTs equipped with UDAF+Mixing systems guarantee a better and a safer airborne contamination control for patients and medical team in comparison with UWD systems. Full article

This paper goes through the process of first designing a feedback system that allows for the measuring of impedance while using the hot snare polypectomy method. The electrosurgical unit used in this study was the Olympus PSD-30. After the impedance-controlled feedback system was completed, the device was tested under a range of power settings from 10 W–50 W. The test was performed ex vivo using porcine colon samples. Using the information gathered from these tests, a technique of determining the threshold of perforation and implementing a system to automatically stop the applied current from the PSD-30 was developed. The data showed that after an increase in impedance of 25% from that of the initially measured impedance, perforation ensued in the tissue samples. Using this information, the device was programmed to interrupt the PSD-30 at this threshold point. This final design was tested and proved able to automatically prevent the event of perforation from occurring, resulting in the ability to prevent serious complications. Full article

The occupational health and safety framework identifies workers with an active implantable medical device (AIMD), such as a pacemaker (PM) or an implantable defibrillator (ICD), as a particularly sensitive risk group that must be protected against the dangers caused by the interference of electromagnetic field (EMF). In this paper, we describe the results of in vitro testing/measurements performed according to the EN50527-2-1:2016 standard, for the risk assessment of employees with a PM exposed to three EMF sources: (1) An electrosurgical unit (ESU); (2) a transcranial stimulator (TMS); and (3) an arc welder. The ESU did not affect the PM behavior in any of the configurations tested. For the TMS and the arc welder, interference phenomena were observed in limited experimental configurations, corresponding to the maximum magnetic field coupling between the EMF source and the implant. The in vitro measurements presented can be considered an example of how the specific risk assessment for a worker with a PM can be performed, according to one of the methodologies proposed in the EN50527-2-1:2016, and can be used as scientific evidence and literature data for future risk assessments on the same EMF sources. Full article

Real-time molecular navigation of tissue surgeries is an important goal at present. Combination of electrosurgical units and mass spectrometry (MS) to perform accurate molecular visualization of biological tissues has been pursued by many research groups. Determination of molecular tissue composition at a particular location by surgical smoke analysis is now of increasing interest for clinical use. However, molecular analysis of surgical smoke is commonly lacking molecular specificity and is associated with significant carbonization and chemical contamination, which are mainly related to the high temperature of smoke at which many molecules become unstable. Unlike traditional electrosurgical tools, low-temperature electrosurgical units allow tissue dissection without substantial heating. Here, we show that low-temperature electrosurgical units can be used for desorption of molecules from biological tissues without thermal degradation. The use of extractive electrospray ionization technique for the ionization of desorbed molecules allowed us to obtain mass spectra of healthy and pathological tissues with high degree of differentiation. Overall, the data indicate that the described approach has potential for intraoperative use. Full article