Bae Hahn-Sol, Lee Mu-Young, Park Ji-Ung
Department of Plastic and Reconstructive Surgery, Seoul National University Boramae Medical Center SM plastic surgery, Seoul, Republic of Korea.
Medicine (Baltimore). 2018 Jan;97(1):e8370. doi: 10.1097/MD.0000000000008370.
Burns at the site of the return electrode (i.e., grounding pad) are possible effects of electrosurgery. Despite this knowledge, however, ignorance or negligence with regards to proper handling of the grounding pads still often occurs. Burn injuries can be easily prevented by taking the necessary precautions; thus, during plastic surgery, careful attention should to be paid.
A 38-year-old female patient was admitted to our ward to be performed augmentation mammoplasty. Before the start of the procedure, the grounding pad was placed on the surgical table and the left calf of the patient was placed on the grounding pad. Before using the endoscope, we found a burn on patient's left calf, where the grounding pad had been placed.
It was a 3-cm-by-3-cm-sized full thickness burn. The surrounding areas had no painful sensation with noninfectious sign.
Debridement and direct closure was performed with elliptical incision of eschar.
The patient did not require additional surgical procedure anymore and satisfied with the scar.
Through this case, we present the appropriate management of electrical burns from a grounding pad, and emphasize the understanding of the mechanism of burn because of electrosurgery, and how to use the grounding pad optimally to minimize the patient's risk.
返回电极（即接地垫）部位的灼伤是电外科手术可能产生的后果。然而，尽管了解这一点，但在接地垫的正确使用方面，无知或疏忽仍经常发生。通过采取必要的预防措施，烧伤很容易预防；因此，在整形手术期间，应予以密切关注。
一名38岁女性患者因隆乳手术入住我们病房。手术开始前，将接地垫放在手术台上，患者左小腿放在接地垫上。在内窥镜使用前，我们发现患者左小腿上放置接地垫的部位有一处灼伤。
这是一处3厘米×3厘米大小的全层烧伤。周围区域无疼痛感觉，无感染迹象。
进行清创，并通过椭圆形切除焦痂直接缝合。
患者不再需要额外的手术，对瘢痕满意。
通过这个病例，我们展示了接地垫电烧伤的恰当处理方法，强调了对电外科手术烧伤机制的理解，以及如何最佳使用接地垫以将患者风险降至最低。
