gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2018)

23.10. - 26.10.2018, Berlin

Cutaneous burns with the use of a radiofrequeny ablation probe during shoulder arthroscopy

Meeting Abstract

  • presenting/speaker Alexandra Pokorny-Olsen - Orthopädisches Spital Speising, Wien, Austria
  • Christian Wurnig - Orthopädisches Spital Speising, Wien, Austria
  • Maria Papakyriacou - MaPaTech, Wien, Austria

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2018). Berlin, 23.-26.10.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocPT28-1486

doi: 10.3205/18dkou836, urn:nbn:de:0183-18dkou8367

Veröffentlicht: 6. November 2018

© 2018 Pokorny-Olsen et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Aim: The aim of the present study was to measure the in-vivo and in-vitro heat generation of an electrocautery device in a sterile and reproducible matter.

Methods: To achieve the in vivo-temperature measurements, we performed shoulder arthroscopies in typical beach chair position. A heat sensor camera (FLIR-E60bx) was used to determine the temperature-rise over time in 10 second intervals.

Additionally, a digital thermometer measured temperature at the endpoint of the outflow hose.

To verify in-vivo measurements and to evaluate in-vitro heat generation of the VAPR (DePuy, Warsaw) electrocautery device under reproducible conditions, further testings were conducted in different settings: free outflow, different outflow suction, blocked outflow, insufficient perfusion. Heat measurement was achieved by the use of a heat sensor camera (FLIR-E60bx)as well as a digital Thermometer. A flow-sensor at the outflow hose measured the outflow-rate to evaluate the suction necessary at the end of the outflow in order to prevent temperature rise.

Results: Analysis of the in-vivo heat sensor data showed temperatures of 55°C-60°C on the surface of the outflow hose, indicating temperatures of more than 60° of the outflow-fluid. The increase in temperature was time-dependent. Levels of over 60°C were reached within the first 40 seconds. The superficial skin temperature did not exceed 31°C at any time. Temperatures measured with the heat sensor camera matched those found with the digital probe.

In vitro-testings achieved similar results with temperature peaks of over 60° in case of insufficient flow, blockage of the outflow or insufficient suction at the end of the outflow hose.

Conclusions: Cutaneous burns after arthroscopy seem to be a rare but severe phenomenon. The high temperature measured in the outflow cable might lead to severe skin burns, which can cause scarring and necessary subsequent surgery.

Use of electrocautery devices during shoulder arthroscopy shows no increase in superficial skin temperature. However, dermal burns can occur, especially with leaking fluid through additional arthroscopy portals or direct contact between the overheated outflow hose of the device and the skin. Surgeons have to be aware of the risk and to use precautionary measures such as sufficient outflow suction.