Are Spark-Gap Electrosurgical Units Safe to Use?
User Experience Network™ [Health Devices Jul 1995;24(7):293]
We have decided to replace our
spark-gap electrosurgical units (ESUs) with a newer technology. However, one of our surgeons
refuses to use the newer ESUs for urology procedures because he states that they are not
as effective as the spark-gap units. Does ECRI have any advice regarding this issue?
The outdated spark-gap units have been
largely superseded by solid-state devices. Although the solid-state units
initially available did not perform as well as spark-gap ESUs during demanding
surgical procedures (e.g., open-heart surgery, transurethral resections), they
have been improved and are now effective in all surgical procedures. Today,
because they decrease the risk of patient burns, they are safer to use than the
spark-gap ESUs. (We previously addressed this issue in 1987; see References.)
Many of the solid-state units have integral return electrode contact-quality
monitors that help to prevent patient burns, whereas most spark-gap units do not have this monitoring
capability. We therefore recommend that you encourage your surgeons to try the newer and safer technology.
Most will find solid-state devices to be acceptable. However, allowing surgeons who
prefer using spark-gap units to continue to use them would likely be safer for patients
than forcing them to use a device that they believe to be unacceptable.
If the surgeons in your institution continue to use the
spark-gap ESU, we recommend that you ensure that they are clearly aware of the safety
risks associated with continued use of these devices. In addition, it may be prudent for
your hospital to obtain signed documentation from these surgeons stating that they are
aware of the safety risks involved and explaining their rationale for continued use of an
Association for the Advancement of Medical Instrumentation (AAMI)/American
National Standards Institute (ANSI). Standard for Electrosurgical Devices.
ECRI. The Bovie CSV: Still accepted? [Consultants Corner]. Health
Devices 1987 Sep-Oct; 6(9-10):340-1.
Electrosurgical Units [11-490]
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