fbpx

What is Electrobisturi Desiccation?

Electrodesiccation leads to the destruction of circumscribed surface tissue areas by a high-frequency current of high voltage (2,000-5,000 V) and low amperage (100-150 mA). When the needle or sphere electrode approaches the skin lesion, a fine spark current flows, through which different degrees of clotting can be achieved. Because this is done by rapid dehydration, it is called desiccation.

This technique differs from electrofulguration, in that the needle or fulguration ball is held very close to the skin (in electrodesiccation, the electrode touches the tissue to be treated). What happens is that the skin quickly becomes whitish and the resulting dry scab peels off on its own. The degree of crusting or charring is higher with electrofulguration. Depending on current density and duration of exposure, two areas develop in the tissue:

  • Drying area.
  • Coagulation site.

In the drying area, specifically in the most damaged part, the conductivity is reduced so that the high-frequency current flows over areas that are not yet sufficiently clotted. As a result, the tissue is allowed to clot uniformly and without gaps. With this technique, different conditions can be successfully treated, which explains its wide use in medicine.

Use of electrodesiccation to treat actinic keratoses

Individual actinic keratoses can be treated with different approaches, such as tangential excision, curettage, or surface electrodesiccation. For actinic keratoses, ablative therapies using erbium laser or carbon dioxide laser are also used, as is high-speed dermabrasion.

With all surgical procedures, a cautious approach is recommended, in case of doubt in several sessions, since superficial scars or depigmentation are the result of an impact or ablation too deep. Complete excision of the focus is always preferable when there is marked cellular atypia on thin-tissue imaging. In this sense, the application of electrodesiccation can be beneficial by:

  • Rapid method of treatment.
  • Low level of pain.
  • Rapid recovery.

Applying drying to treat Bowen disease

Bowen disease is a carcinoma in situ with a clinical and histologic appearance. It occurs predominantly after age 50 and there is no spontaneous regression of the disease. Thus, the focus needs to be completely removed.

The method of choice is surgical excision, if possible, with control of the incision margin. In the case of limb or phalanx location, posterior plastic covering by autologous skin transplantation is usually necessary because of the size of the foci. Ablative laser surgery, cryosurgery, electrodesiccation, and curettage are often inadequate therapeutic procedures because of deeper involvement of hair follicle epithelium and sebaceous gland excretory ducts and result in relative frequency of recurrence.

However, curettage and electrodesiccation, which are most commonly used in the Anglo-American world, are considered third-choice therapeutic alternatives. It should be reserved for small initial or superficial basal cell carcinomas in nonproblem areas. The same is true of cryotherapy using cryoprobes or sprays.

The depth effect can only be insufficiently controlled even with the use of subcutaneous temperature sensors. Superficial ablative procedures, such as carbon dioxide laser ablation or dermabrasion, can also be used for the treatment of basal cell carcinoma of the skin of the superficial trunk; in this case they represent a very valuable treatment modality, especially in the case of multiple tumors. Monitoring for relapses should be done as close as possible. Indications for electrosurgery include:

  • Intraoperative hemostasis
  • Electrocaustic ablation of condylomata acuminata, pendular fibromatoids, senile angiomas, warts vulgaris
  • Electrodesiccation and curettage of seborrheic keratoses and, in specific cases, of superficial cutaneous trunk basaliomas (the latter is often done in English-speaking countries)

Kalstein electrosurgical generator: an option to consider

Kalstein’s electrosurgical generator is a versatile equipment that supports a variety of surgical procedures, where it is required to control the current supplied. When reviewing the page of these teams HERE, instruments are found that have the most outstanding features:

  • Current Control and Compensation
  • Automatic recognition of the return electrode used
  • A system to eliminate unpleasant fumes can be included as an option

This equipment, which is ideal for a surgical unit in gynecology and plastic surgery, can be reviewed on the company’s home page HERE, where it is also possible to consult the price, clarify doubts, quote or manage the purchase. HERE