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I just came across a Select PSS 238 High Frequency Desiccator buried and untouched in my office (purchased by a prior administrator when the practice opened...longer story than what it's worth). Anyhow, I'm curious as to how this type of unit fits into a podiatry practice (other than cautery for surgical bleeders). Is a desiccator the same as a hyfrecator? Are both used for 'electrosurgery'? Is 'electrosurgery' the same as 'radiosurgery'? Are there any protocols on use of such a device?

Any insight is appreciated.
Thanks,
Matthew

 

I use a hyfrecator to treat verrucae; the method has a bad reputation for causing scarring in medical circles. Scars are usually the result of poor technique or patient choice.

Briefly:
Patient choice: no pacemaker, not obese, no LA allergy, "good healer"
1. LA given
2. Reduce Lesion to level
3. If lesion on toe, protect adjacent digit with finger from latex glove
4. Set unit to 70%
(I use my unit as a Mono Polar electro desiccator (MPED) I do not use calf plate, colleagues bad experience (Leg burn))
5. Touch point on wart/skin demarcation line give a brief zap (technical term)
6. Repeat around the lesion, then systematically zap rest of the lesion
7. Using scalpel reduce burned tissue usually <1mm
8. Staying just inside the margin of the lesion repeat and reduce
9. Third zapping will usually cause dermal junction of the lesion to separate.
10. Tidy up lesion with scalpel, any "large" blood vessels should be cauterised using MPED touch
11. Base and sides of les may have capillary seepage: reduce unit setting to 30% and "Toast" the entire lesion with an arc of electricity (fulguration) holding the point 0.5mm from the tissue.
12. Flush with betadine and apply sterile dressing 7mm SCF aperture pad tape and Tubigrip overlay. Pain relief advice & Rest.
13. "Keep dry", Re-dress 7 days, give tape, dressings & 10 Ml betadine in dropper bottle (best to give an antiseptic as patients like to use something: one patient used a strong steroid cream)
14. Try to get the lesion dry ASAP: after shower, dry with tissue & hairdryer then re-dress.
15. Lesion is slower to heal than blunt dissection, up to 5 weeks, as it is an electrical burn.
16. I have a success rate of about 75%

Hyfrecation is where you stick the probe deep into the lesion and zap away until you cannot see the sparks any more due to tissue carbonisation. This will cause a scar every time!

€z
(I have just signed up to Picasa to upload a series of pix hope this is the correct link)

http://picasaweb.google.com/Afoot01...EwAE&feat=email#slideshow/5546588910029591698

 

Can anyone tell me where I can train for Electrosurgery. I have emailed the society but so far have not had a reply. No one seems to offer this training any more that I can see.

Anyone know anything about this training?

Thanks

 

I did hundreds of electro-desiccations of plantar warts in the 70's. We used a "Ritter Hyfrecator" (?...spelling....?). Given - expertise of technique, choice of patient and lesion etc, the success rate from every point of view was exceedingly good. I stopped doing them because a) I decided that routine treatment of warts was wrong, and 2) left practice.

 

Foot in mouth, I have sent you a Pod Arena private message!