Deml Moritz C, Goost Hans, Schyma Christian, Kabir Koroush, Hoppe Sven, Deborre Christoph
Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Rheinische Friedrich-Wilhelms-University, Bonn, Germany.
Department of Orthopedics and Trauma Surgery, Inselspital Bern, University Hospital Bern, University Bern, Bern, Switzerland.
Technol Health Care. 2018;26(2):239-247. doi: 10.3233/THC-160706.
Piercings are placed at different body sites often invisible to medical staff. They may cause additional injuries in trauma and emergency surgery by electro-cautery.
To clarify whether electrosurgery will have a direct damaging effect to the skin around a pierced skin area.
Metallic piercings were fixed at defined distances from the neutral and active electrode on abdominal pig skin. The distance of the active electrode was reduced by 5 mm increments to 0. The respective increases in temperature were determined with a thermal camera. A macroscopic and histological analysis of the area around the piercing to detect thermal damage was carried out.
Significant increases in temperature and visible changes in the tissue around the piercing only occurred when the active electrode was in direct contact with the piercing (increase of 47.3∘C). Electro-cautery in distance of 5 to 10 mm to the piercing showed only temperature increases of less than 5∘C.
If metallic piercings are not directly touched by the active electrode and the distance is more than 5-10 mm, no clinically relevant effect is created on the tissue in direct proximity to the piercings by electro-cautery. In an emergency surgery situation, a piercing not fixed in direct proximity to the surgical field may likely be ignored.
穿刺部位通常在医务人员视野之外的身体不同部位。在创伤和急诊手术中，它们可能因电灼而导致额外损伤。
阐明电外科手术是否会对穿刺皮肤区域周围的皮肤产生直接损伤作用。
在腹部猪皮上，将金属穿刺物固定在距中性电极和活性电极一定距离处。活性电极的距离以5毫米的增量减小至0。用热成像仪测定相应的温度升高。对穿刺周围区域进行宏观和组织学分析以检测热损伤。
仅当活性电极与穿刺物直接接触时，穿刺周围组织的温度才会显著升高且出现可见变化（升高47.3摄氏度）。距穿刺物5至10毫米处进行电灼时，温度仅升高不到5摄氏度。
如果活性电极未直接接触金属穿刺物且距离超过5 - 10毫米，电灼对紧邻穿刺物的组织不会产生临床相关影响。在急诊手术情况下，未紧邻手术区域固定的穿刺物可能可被忽略。
