Preventing Patient Burns and Skin Tears When Using Electrosurgical Units

Electrosurgery is used to rapidly cut soft tissue and control bleeding during a variety of surgical procedures. [1][2]2][3] Some commonly reported complications from electrosurgery include electrical burns, 1,4,5 surgical fires, 1,5,6 electric shock, 4 and malfunction of implanted medical devices such as pacemakers. 4A review of event reports recently submitted to the Pennsylvania Patient Safety Reporting System (PA-PSRS) identified complications that were less commonly referenced when reviewing the literature about electrosurgery complications: burns from a metal instrument that was in contact with the electrosurgical unit (ESU) and skin injuries from the ESU grounding pad.Knowledge about the principles of electrosurgery 2 and how ESUs work 2,7 can help prevent complications that may pose a risk to patient safety.An electrosurgery generator unit powers an electrical current that flows through the cutting and/or coagulation instrument.There are two electrosurgery modalities, monopolar and bipolar. 2,4Monopolar electrosurgery (Figure 1) is the most common modality used in surgical procedures.In monopolar electrosurgery, the handheld device (the device used by the surgeon) is pencil shaped, with a single tip.The current flows from the generator to tip and then into the patient's tissue.The current then exits the patient via a grounding pad that is adhered to the patient's body to complete the electrical circuit and flows back to the generator. 2,4,8