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BOVlE SPECIALIST ELECTROSURGICAL UNIT
2. Operation
For effective coagulation on a large growth,
length of time is more important than the amount of
current. The Specialist graphic indicates suggested
power adjustinents or settings for the type of elec-
trode indicated. Emphasis again is 'placed on the
many procedures where variations i n power set-
tings depend largely on the experience and judg-
ment of the surgeon. The process of coagulation is
dependent on areas of highest current concentra-
tion where dehydration and carbonization will occur
first. Skilled surgeons in their procedures have
found short times with high power are not as effec-
tive as low power and longer times if deeper pene-
tration is desired.
I n applications of a penetrating needle elec-
trode, coagulation begins at its point, this being the
area of highest current density. Dehydration occurs
and loss of conductivity at this point forces current
to dehydrate successive areas of less penetration.
While the current is left on, the ascending area of
coagulum, broadens in a cone-like fashion until it
becomes evident at the surface. Ball or flat blade
electrodes in contact with tissue for coagulaton
purposes depend on area of contact, power setting
and time to produce the clinical requirement. The
effect is a dehydration of descending nature towards
the dispersive electrode.
DESICCATION AND FULGURATlON
Desiccation is usually a bi-terminal technique
with dispersive electrode. Many surgeons find the
amplitude controlled cut with hemostasis waveform
ideal for this precise form-of coagulation. You will
find that spark intensity diminishes as the cut power
control is turned to lower settings. Phis produces
the short fine spark appropriate for dermatology
and facial surgery.
I n the process of fulguration, the coagulation
current jumps from a pointed active electrodeto the
large mass of the patient. Fulguration being a sur-
face dehydrator, becomes self-limiting, since dehy-
drated areas are non-conductive to currents. The
same effect happens if the active electrode becomes
coated with coagulum.
The effectiveness of desiccation and fulgura-
tion are superficial, and therefore are preferred
when cosmetic results are important.
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