Higher currents, greater risks: preventing patient burns at the return-electrode site during high-current electrosurgical procedures.

Patient burns at the site of the return electrode are a well-known, and generally well-managed, risk of electrosurgery. However, the use of newer electrosurgical devices and techniques that apply higher currents to the patient for longer periods of time has created a new set of burn risks. And the safety measures that have proven effective during conventional electrosurgery can not necessarily be relied on to prevent return-electrode-site burns during these high-current, long-activation-time electrosurgical procedures. In this article, we explain the hazards and detail the factors that can increase the risks of return-electrode-site injuries for a given procedure. We also provide recommendations to help facilities and clinicians minimize those risks.