Diathermy - Surgical Diathermy Procedure and Treatment

Surgical diathermy is a special electrical unit generating a high frequency current which produces heat when passed through tissues.Depending upon the speed of the current and the resulting heat, a diathermy unit can achieve the following results:

1. Cutting with high Speed or intensity.

2. Coagulation (cooking compared to burning due to heated needle in electrocautery).

(a) If weak, epilation.

(b) If strong, coagulation producing destruction.

3. Desiccation (fulgration) ensues by passing medium current through a mono-terminal electrode at a slight distance from the surface which produces sparking heat and results in drying up the tissues.

In practice, these three processes overlap each other in the same unit, depending upon the intensity and speed of the current. Before treating patients, the practitioner must familiarize himself with the basis of its working, the different regulators controlling the resistance and amperage and the electrodes-the indifferent electrode and the active, operating electrode which varies in shape and size to suit different surgical requirements.

Surgical diathermy is usually bloodless and aseptic, hence its usefulness is enhanced. Unless very weak currents are used, as in epilation or mild desiccation, preliminary local anesthesia is essential. Hyfrecator is a compact diathermy unit.

Indications of diathermy

1. Epilating current - Epilation of superfluous hair, spider naevi, dilated capillaries as in rosacea, verruca plana on face.

2. Electro-coagulation common warts, verruca vulgaris, seborrhoeic warts, pyogenic granuloma, senile keratoses, mucous cysts, acanthomas, basal cell epithelioma.

3. Electro-cutting-For excision of cutaneous lesions including biopsy, keloid, malignant neoplasm and plantar wart.

4. Electro-desiccation- This may be combined with curettage (dermal steel curettes are employed for the purpose) which precedes or follows desiccation depending upon the individual needs of the patient-Warts, both plane and filiform xanthelasma, condyloma acuminatum, adenoma sebaceum and skin tags.

Since the ultimate completeness of the cure and the cosmetic results are the important criteria for judgment, the operator must take all the facts into consideration before selecting a particular procedure for a patient.

Superficial wounds are left open and only a mild antiseptic cream or powder applied twice a day till the wound heals. In deeper lesions, particularly in the summer an antiseptic dressing is used. These wounds heal more slowly than surgical wounds.