Precautions and safety measures

Radiofrequency surgery equipment is an electrical gadget. Hence, the precautions and safety measures related with the hazards of electric current are the main concern. The manufacturer always takes full safety measures not to allow any leakage of electric current during the use of the equipment. Yet, there are certain issues one should know before giving the treatment.

Patient Safety Issues

Cardiac pacemakers and radiofrequency surgery

Cardiac pacemakers have an electric circuit (battery operated). Today’s pacemakers are far better protected from electrical cross circuits than a few decades back, yet it is always safe to avoid radiofrequency surgery in such patients. The radio waves travel through the body of the patient toward the antenna plate as mentioned on page 24, Figure 7.1, Chapter 7. These waves have the potential to affect the pacemaker function. Some practitioners advise either to keep the antenna plate far away from the vicinity of the pacemaker to avoid the radio waves disturbing the pacemaker circuit or delivering radiofrequency waves in bursts of less than 5 seconds to avoid the same problem. A prior consent from the patient’s cardiologist is a must before performing radiofrequency surgery for such patients. I prefer avoiding radiofrequency surgery in such patients. If needed, these patients can be safely treated with other modalities. I have included a statement in my informed consent forms that confirms the patient does not have a cardiac pacemaker. This form has to be duly signed separately for our safety.1–3 Refer to Chapter 11 for more information about the consent form.

Electrical shock

It is advisable to check that the patient’s skin does not have a direct contact with any metal, which makes the patient prone to electrical shock. Ideally, a dental metal implant or some other metal objects like watches, jewelry, earrings, and spectacles have not led to electrical shock so far in my practice. It is impractical to ask patients to remove everything before office dermatologic surgery. Dental metal implants are fixed. I have observed that the patient reports some heat or pain where there is close skin or mucosal contact of metal. This is more common if the surgical site is in the vicinity of the metal as the radio waves delivered from the active electrode while passing through the body toward the antenna plate heat the metal.

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