In monopolar electrosurgery, the current that penetrates the patient's body through the monopolar pen electrode returns to the device through the plate, also known as the neutral electrode. Correct usage and appropriate placement of the plate are crucial for ensuring the effective and safe use of monopolar electrosurgery. Plates are available in different types, including one-piece and two-piece designs.
- Consider Dual-pad Plates for Enhanced Safety
- To enhance patient safety, it is advisable to utilize double plates. The use of two-piece plates significantly reduces the risk of unintended burns at the site of the plate. When using one-piece plates, the device cannot control the quality of contact between the plate and the patient.
- Prevent Increased Current Density
- A reduced contact surface of the neutral electrode or its inadequate connection with the patient's body can elevate the current density, potentially resulting in burns at the contact site. Kavandish System's devices are equipped with a system to monitor the status of the patient's plate, ensuring patient safety and mitigating burns caused by improper plate-to-patient connection. If there is an issue with the contact quality of the double plate with the patient's body, the device detects it and triggers an alarm.
- Optimal Placement of the Plate
- The entire flat side of the current conductor from the plate should be securely affixed in a suitable location where normal blood circulation is possible, such as the upper arm or upper thigh, closest to the surgical site. This minimizes the current path between the monopolar active electrode and the plate, avoiding the passage of current through the heart and lungs.
Suggested plate attachment locations according to the surgical site
- Ensure Adequate Contact Surface
- Place the plate to establish a substantial contact surface with the patient's skin. Insufficient contact may lead to increased current density in the contact area, potentially resulting in burns.
Reduction in efficient contact surface between the patient and the plate
Electric current conducting area
An area that does not conduct electric current, because it does not have contact with the skin, or because it is oxidized or contaminated with fat particles, resulting in very weak conduction.
- Enhance Skin Conductivity
- Increase the electrical conductivity of the skin in the area where the neutral electrode is positioned by cleaning, massaging to improve blood flow, and shaving the hair from the contact area.
- Mindful Placement
- Avoid situating the plate over large blood vessels, bones, or areas with poor blood circulation.
- Plate Maintenance
- Adhere to the manufacturer's guidelines and ensure the patient's plate remains unaltered, free from tears or cuts.
- Cable Insulation
- Regularly inspect the insulation of the cable connected to the neutral electrode for any damage.
- Patient Mobility
- Upon moving the patient, verify the correct connection of the plate.
- Consider Implants
- If the patient has conductive implants, position the plate to avoid current flow through these areas.
- Pacemaker and Electronic Devices
- In cases where the patient has a pacemaker or other implanted electronic devices, take precautions to minimize interference, such as consulting a cardiologist, using reliable monitoring equipment, and ensuring the availability of an electroshock device.
- Polymer Plate Usage
- When using polymer plates, ensure the use of silicone and standard types to prevent burns. Worn or old polymer plates may deteriorate in quality over time.
- Permanent Plates
- Apply suitable gel uniformly on the entire surface of permanent plates, secure the plate's position using rubber bands to maintain good contact with the patient's skin.
- Moisture Prevention
- During the operation, prevent fluids or moisture from reaching the contact area of the plate, as these can increase the risk of burns.
- Avoid Improper Methods
- Refrain from using water, saltwater solutions, or wet cloths to improve the plate's contact with the patient.