Simulation studies of surgical electrode design to prevent sparking enhanced skin burns during electrocautery

Marija Radmilović-Radjenović, Dimitrije Radjenović, Vojislav Milošević, Branislav Radjenović

Abstract


Proper care and handling of electrosurgical equipment are essential to patient and personnel safety.  Burns that destroy layers of the patient’s skin often linked to a medical mistake are largely preventable. This paper is dealing with the design of surgical electrodes as one of the extremely important factors for the formation of burns during standard procedures. Simulations have been performed by using the COMSOL simulation package for various electrode configurations (cylinder-cylinder, sphere-sphere, cylinder-sphere, cylinder-cone, sphere-cone, and cone-cone)  representing shapes of surgical electrodes. The primary goal was to determine the location and the voltage required for sparking. The obtained simulation results agree well with the experimental data taken from literature revealing that the sparking formation is strongly affected by the electrode configuration. Sparking occurs most easily when both electrodes are cylindrical and the most difficult when one electrode is a cone. It was also found that the sparking mechanism is not the same in both directions between the active electrode and passive metal plate due to electrical asymmetries.  Electrical asymmetries may lead to differences in breakdown voltage even to 40%.  Since the asymmetry is the cause of undesirable direct current burns and neuromuscular electrostimulation, and the conformity process does not take into account the sparking phenomena, the certification process for this class of equipment must change. Results presented here can be used to establish practices for the safe use of the electrocautery device and to prevent injury to patients and staff.


Keywords


Electrocautery, electrode configuration, skin burns, surgery.

References


D.J. Marsh, A. Fox, A.O. Grobbelaar, and J.S. Chana, “Abdominoplasty and seroma: a prospective randomised study comparing scalpel and handheld electrocautery dissection,” J Plast Reconstr Aesthet Surg., vol. 68, pp. 192-96, 2015.

L.D. Prakash, N. Balaji, S.S. Kumar, and V. Kate, “Comparison of electrocautery incision with scalpel incision in midline abdominal surgery–A double blind randomized controlled trial,” Int J Surg., vol. 19, pp. 78-82, 2015.

A. Ismail, A.I. Abushouk, A. Elmaraezy, A. Menshawy, E. Menshawy M. Ismail, E. Samir, A. Khaled, H. Zakarya, A. El-Tonoby, and E. Ghanem, “Cutting electrocautery versus scalpel for surgical incisions: a systematic review and meta-analysis,” Journal of Surgical Research, vol. 220, pp. P147-63, 2017.

J. Bastianpillai, C. Saxby, P. Coyle, A. Armstrong, W. Mohamid, and G. Mochloulis, “ Evaluating nasal cautery techniques in epistaxis,” J. Laryngol Otol., vol. 133, pp. 923-927, 2019.

M. Saaiq, S. Zaib, and S. Ahmad, “Electrocautery burns: experience with three cases and review of literature,” Ann Burns Fire Disasters, vol. 25, pp. 203–06, 2012.

F.M.B. Bisinotto, R.A. Dezena, L.B. Martins, M.C. Galvao, M.C. Sobrinho, and M.S. Calcado, “Burns related to electrosurgery – Report of two cases,” Brazilian Journal of Anesthesiology, vol. 67: pp. 527-34, 2017.

J.F. Stoltz, D. Bensoussan, V. Decot, A. Ciree, P. Netter, and P. Gillet, “Cell and tissue engineering and clinical applications: an overview,” Biomed Mater Eng., ; vol. 16, pp. S3-18, 2006.

B. Sheikh, “Safety and efficacy of electrocautery scalpel utilization for skin opening in neurosurgery,” Br.J.Neurosurg., vol. 18 pp. 268-72, 2004.

S. Grimnes, “Dielectric breakdown of human skin in vivo,” Med. Biol. Eng. Comp., vol. 21, pp. 379–81, 1983.

B.J. Schneider, and P.J. Abatti, “Electrical characteristics of the sparks produced by electrosurgical devices,” IEEE Trans. Biomed. Eng., vol. 55, pp. 589–293, 2008.

M. Radmilović-Radjenović, B. Radjenović, M. Klas, A. Bojarov, and Š. Matejčik, “The breakdown mechanism in electrical discharges: The role of the field emission effect in direct current discharges in microgaps,” Acta Physica Slovaca, vol. 63, pp. 105-205, 2013.

Y. Liu, W. Wang, W. Zhang, F. Ma, Y. Wang, B. Rolfe, and S. Zhang, “Study on Breakdown Probability of Multimaterial Electrodes in EDM,” Advances in Materials Science and Engineering, vol. 2018, pp. 2961879, 2018.

A.M. Loveless, G. Meng, Q. Ying, F. Wu, K. Wang, Y. Cheng, and A.L. Garne, “The Transition to Paschen’s Law for Microscale Gas Breakadown at Subatmospheric Pressure,” Sci. Rep., vol. 9, pp. 5669, 2019.

L.K. Warne, R.E. Jorgenson, and E.E. Kunhardt, “Criterion for spark-breakdown in non-uniform fields,” Journal of Applied Physics, vol. 115, pp. 143303, 2014.

W.J.M. Brok, E. Wagernaas, J. Van Dijk, and J.J.A.M. Der Mullen, “Numerical Description of Pulsed Breakdown Between Parabolic Electrodes,” IEEE Transactions on Plasma Science, vol. 35, pp. 1325-1334, 2007.

M. Radmilović-Radjenović D. Radjenović, and B. Radjenović, “Simulation studies of the electrode configuration effect on the breakdown phenomenon,” International Journal of Advanced Research in Computer Science and Electronics Engineering, vol. 8, pp. 68-72, 2019.

F. Picard, A.H. Deakin P.E. Riches, K. Deep, and J. Baines, “Computer assisted orthopaedic surgery: Past, present and future,” Medical Engineering & Physics, vol. 72, pp. 55-65, 2019.

Lin CL, Lan GJ. A computational approach to investigate optimal cutting speed configurations in rotational needle biopsy cutting soft tissue. Computer Methods in Biomechanics and Biomedical Engineering 2018; 21:84-83.

T.M. Morrison, M.L. Dreher, S. Nagaraja, L.M. Angelone, and W. Kainz, “The Role of Computational Modeling and Simulation in the Total Product Life Cycle of Peripheral Vascular Devices,” J. Med. Device, vol. 11, pp. 024503, 2017.

COMSOL Multiphysics. Stockholm,Sweden, www.comsol.com.

A.E. Tammam, H.H. Ahmed, A.H. Abdella, and S.A.M. Taha, “Comparative Study between Monopolar Electrodes and Bipolar Electrodes in Hysteroscopic Surgery,” J. Clin. Diagn. Res., vol. 9, pp. QC11–Q13, 2015.

R. Assaf, T. Albahhah, K. Ayoub, Z. Al-Janzir, M. Tarzi, A.R. Rahmeh, and I. Al-Hadid, “Penile reconstruction using scrotal flap after usage of monopolar electrocautery in a 2-month-old Syrian child: a case report,” Journal of Surgical Case Reports, vol. 2019, pp.1-3, 2019.

J. Lee, J.R. Cho, M.H. Kim, H.K. Oh, D.W. Kim, and S.B. Kang, “Surgical outcomes according to the type of monopolar electrocautery device used in laparoscopic surgery for right colon cancer: a comparison of endo-hook versus endo-shears,” Surgical Endoscopy, vol. 34, pp. 1070–76, 2020.

A. Kousha, R. Banan, N. Fotoohi, and R. Banan, “Cold dissection versus bipolar electrocautery tonsillectomy,” J. Res. Med. Sci., vol. 12, pp. 117-20, 2007.

M.R. Mofatteh, S. Meghdadi, G. Sharifzadeh, F. Salehi, and M.M.H. Taheri, “A study of the Complications of Bipolar Electrocautery Tonsillectomy in Patients Admitted to Vali-e-Asr Hospital of Birjand,” Journal of Surgery and Trauma, vol.3, pp. 33-38, 2015.

V. Singh, and P. Kumar, “Modified microdissection electrocautery needle,” Natl. J. Macillofac. Surg., vol. 5, pp. 243-244, 2014.

R.K. Sahu, and M. Midya, “Creating a microdissection cautery tip using disposable needle,” J. Cutan. Aesthet. Surg., vol. 12, pp. 248-249, 2019.

R.P. Guha, and S. Giri, “Cautery Burns: Prevention Better than Cure!.,” Indian Journal of Surgical Oncology, vol.10, pp. 439–440, 2019.

S. Kumar, R. Bikkasani, F. Shariff, and J. Jaffar, “Electrocautery burns of genitalia during lumbar spine surgery,” Journal of Clinical Orthopaedics and Trauma, vol. 10, pp. S139-S142, 2019.

M. Radmilović-Radjenović, and B. Radjenović, “Studies of the origin of skin burns during electrocautery based on multi-component plasma fluid model,” Journal Surg. Surgical Research, vol. 6, pp. 27-29, 2020..

AC/DC Module User's Guide, pp. 75-84, COMSOL AB, Stockholm,Sweden. Available at: https://doc.comsol.com/5.4/doc/com.comsol.help.acdc/ACDCModuleUsersGuide.pdf,

M.H. Wang, and W.H. Chang, “Effect of Electrode Shape on Impedance of Single HeLa Cell: A COMSOL Simulation,” Bio.Med. Research International, vol. 2015. pp. 871603, 2015.

A.K. Alkaabi, and J.C. King, “ Benchmarking COMSOL Multiphysics Single-Subchannel Thermal-Hydraulic Analysis of a TRIGA Reactor with RELAP5 Results and Experimental Data,” Science and Technology of Nuclear Installations, vol. 2019, pp. 4375782, 2019.

E.V. Ostroverkhov, V.V. Denisov, I.V. Lopatin, and N.N. Koval, “Effect of the mesh emission electrode shape on the distribution of the plasma density generated in the working chamber,” J. Phys. Conf. Ser., vol. 1115, pp. 032012, 2018.

J.M. Meek, J.D. Craggs, Electrical breakdown of gases. Oxford, UK: Oxford Press, 1953.

E.J. Dias, B.J. Schneider, and E. Ribeiro, “On the origin of skin burns and neuromuscular electrical stimulation as a consequence of electrosurgical procedures,” Research Biom. Eng., vol. 35, pp. 111–122, 2019.


Full Text: PDF

Refbacks

  • There are currently no refbacks.




 


All Rights Reserved © 2012 IJARCSEE


Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 Unported License.