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| Year : 2009 | Volume
: 75
| Issue : 8 | Page : 83--89 |
Standard guidelines for electrosurgery with radiofrequency current
Sharad Mutalik
Member, IADVL Taskforce on Dermatosurgery, 2008-2009*, Skin and Cosmetology Clinic, Pune, India
Correspondence Address:
Sharad Mutalik
Samruddhi Apartments, B Wing, 95/A/2 Shivajinagar, Pune - 411005
India
 Source of Support: None, Conflict of Interest: None  | Check |
Definition: Radiofrequency (RF) induces thermal destruction of the targeted tissue by an electrical current at a frequency of 0.5 MHz (RF). As the electrode tip is not heated, there is minimal thermal damage to the surrounding tissues, producing good esthetic results. Therefore, RF ablation is also known as cold ablation or "coblation." Modality: It has three modes of operation: (a) Cut, (b) cut and coagulate and (c) coagulate. Therefore, it can be used for various purposes like incision, ablation, fulguration, shave excision and coagulation. Because of the coagulation facility, hemostasis can be achieved and operation becomes easier and faster. Indications: It is effective in treating various skin conditions like dermatosis papulosa nigra, warts, molluscum contagiosum, colloid milia, acquired junctional, compound and dermal melanocytic nevi, seborrheic keratosis, skin tags, granuloma pyogenicum, verrucous epidermal nevi, xanthelesma, rhinophyma, superficial basal cell carcinoma and telangiectasia. It can also be used for cosmetic indications such as resurfacing, earlobe repair and blepharoplasty. Anesthesia: The procedure is accomplished either under topical anesthesia eutactic mixture of local anesthetics or local injectable anesthesia, under all aseptic precautions. Procedure: While operating, only the tip of the electrode should come in contact with the tissue. Actual contact of the electrode with the tissue should be very brief in order to prevent excessive damage to the deeper tissues. This can be accomplished by moving the electrode quickly. Complications: Complications are uncommon and mainly occur due to an improper technique. The treating physician should be aware of the contraindications of the procedure as listed in these guidelines. Physician qualification: RF surgery may be performed by a dermatologist who has acquired adequate training during post-graduation or through recognized fellowships and workshops dedicated to RF surgery. He/she should have adequate knowledge of the equipment and pre- and post-operative care. Blepharoplasty and full-face resurfacing need specialized training at dedicated workshops/centers. Facility: The procedure may be performed in a physician's minor procedure room. For advanced procedures and situations like treating certain lesions such as vascular lesions, facial resurfacing and blepharoplasty, a fully equipped minor theater may be preferred.
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