ABSTRACT
BACKGROUND: Guidelines exist for minimizing potential electromagnetic interference (EMI) with electrosurgical equipment in patients with cardiac rhythm management (CRM) devices. These guidelines encompass all electrosurgical devices but are not specific for hyfrecators. OBJECTIVE: To investigate the potential interference of CRM devices by hyfrecators. MATERIALS AND METHODS: Using a collagen-based saline gel, three implantable pulse generators (pacemakers) and three implantable cardioverter defibrillators were tested to measure the EMI from two commonly used hyfrecators. The six devices were tested using the hyfrecator under normal use settings and on maximum power. RESULTS: Hyfrecators did not interfere with defibrillators and affected pacemakers only when used in close proximity to the device. For the pacemakers, atrial inhibition was observed at a distance of 3 cm on maximum hyfrecator settings and 1 cm at normal use settings. Ventricular inhibition occurred in very close proximity to the device (<1 cm) or in direct contact. CONCLUSION: Hyfrecators are safe to use in patients with defibrillators and can be used in pacemaker patients within 2 inches of the device perimeter.
Subject(s)
Defibrillators, Implantable , Electromagnetic Fields/adverse effects , Electrosurgery/instrumentation , Hemostasis, Surgical/instrumentation , Models, Structural , Pacemaker, Artificial , Electric Conductivity , Electrosurgery/adverse effects , Hemostasis, Surgical/adverse effects , HumansSubject(s)
Carcinoma, Basal Cell/therapy , Carcinoma, Squamous Cell/therapy , Skin Neoplasms/therapy , Carcinoma, Basal Cell/etiology , Carcinoma, Basal Cell/genetics , Carcinoma, Basal Cell/pathology , Carcinoma, Squamous Cell/etiology , Carcinoma, Squamous Cell/genetics , Carcinoma, Squamous Cell/pathology , Curettage , Desiccation , Disease Progression , Humans , Immunosuppression Therapy/adverse effects , Intraoperative Period , Mohs Surgery , Polymethacrylic Acids/therapeutic use , Radiotherapy/adverse effects , Recurrence , Risk Factors , Skin Neoplasms/etiology , Skin Neoplasms/genetics , Skin Neoplasms/pathology , Tarlov Cysts/pathologySubject(s)
Carcinoma, Merkel Cell/therapy , Skin Neoplasms/therapy , Algorithms , Carcinoma, Merkel Cell/diagnosis , Carcinoma, Merkel Cell/drug therapy , Carcinoma, Merkel Cell/radiotherapy , Carcinoma, Merkel Cell/surgery , Follow-Up Studies , Humans , Sentinel Lymph Node Biopsy , Skin Neoplasms/diagnosis , Skin Neoplasms/drug therapy , Skin Neoplasms/radiotherapy , Skin Neoplasms/surgeryABSTRACT
The article focuses on forehead reconstruction of surgical wounds following skin cancer resection. Reconstruction options are presented for three forehead subunits. Preserving motor and, when possible, sensory nerve function, maintaining eyebrow position, and camouflaging incisions are priorities for successful reconstruction. Most forehead defects that cannot be closed primarily are usually reconstructed with laterally based advancement flaps.
Subject(s)
Forehead/surgery , Plastic Surgery Procedures/methods , Eyebrows/anatomy & histology , Facial Muscles/anatomy & histology , Facial Muscles/surgery , Forehead/anatomy & histology , HumansABSTRACT
The article focuses on scalp reconstruction of surgical wounds following skin cancer resection. In contrast to other cosmetic units, scalp wounds are closed under significant tension, because the galea restricts overlying tissue movement. For defects that cannot be closed primarily, rotation flaps developed within the subgaleal space are often the best reconstruction option.
Subject(s)
Plastic Surgery Procedures/methods , Scalp/surgery , Humans , Scalp/anatomy & histology , Surgical FlapsABSTRACT
OBJECTIVE: The purpose of this study was to provide an update and overview of the current indications for Mohs micrographic surgery (MMS) for cutaneous and upper aerodigestive tract malignancies. STUDY DESIGN: Literature review. METHODS: A comprehensive review of the literature from 1971 to present was completed by using the Medline data base. In addition, interviews were obtained with several otolaryngologists who had used the technique. RESULTS: MMS offers a superior alternative to standard excision in a variety of cutaneous malignancies. Overall, for the skin cancers likely to be encountered by the otolaryngologist, there is significant evidence that MMS offers increased rates of cure as well as tissue conservation. The role of MMS in upper aerodigestive tract malignancies continues to evolve and multiple issues must be addressed before its general application. CONCLUSIONS: When confronted with a difficult cutaneous malignancy, the otolaryngologist should consider MMS to optimize treatment results.
