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Treatment with electric current in modern medicine is a fairly common practice. One of these methods is diathermocoagulation, often used for bloodless dissection of tissues and stopping bleeding. The procedure is carried out using a special diathermocoagulator apparatus. But it would be wrong to think that only surgeons use this device. Diathermocoagulators are often indispensable in gynecology, dentistry and other areas of medicine. In addition, the creation of this device gave rise to the development of a new industry – electrosurgery (surgical treatment using high-frequency current).
What is a diathermocoagulator
With the help of diathermocoagulators, bleeding from small vessels is stopped, and tissues are also dissected. There are many options for devices of this type on the medical equipment market. For example, DKS-30 is more often used in dentistry, DKH-250 is intended for electrosurgeons, and DKU-60 is positioned by the manufacturer as a universal model.
The structure and functionality of models from different manufacturers may vary somewhat, but they all have much in common. Any diathermocoagulator is actually the device itself with a power adjustment function, electrodes and a set of different attachments (blades, loops, electric knives).
Devices for diathermocoagulation can be stationary or portable. If surgery is to be done on a large area of the body, then a special kind of device is taken into work – a spray coagulator. With its help, an electric arc is created above the working surface, under which, in fact, an incision is formed. Diathermocoagulators are electrosurgical and argon. The second version of the equipment, in addition to electricity, involves the use of argon. Thanks to the gas, a layer of plasma is created between the tip of the device and the tissue, which serves as a conductor and at the same time prevents the tip from sticking to the surface.
The diathermocoagulator can create both superficial and deep exposure to high frequency alternating current on the tissue. This means that diathermocoagulation can be useful for the treatment of superficial wounds and skin lesions, as well as in the case of pathologies of internal tissues and organs. An example of a superficial effect of a diathermocoagulator is the procedure for removing warts. Speaking about the effect on internal organs, most often they mean cauterization of erosions on the cervix and genital warts, treatment of dysplasia and some other gynecological diseases.
Operating principle
The principle of operation of the diathermocoagulator is based on the laws of physics. Or rather, the one that says that under the influence of high temperatures, organic proteins fold. Due to the electric current, the electrodes of the diathermocoagulator heat up to a high temperature and, upon contact with the body, cause coagulation – the very folding of proteins.
The electrosurgical effect of the diathermocoagulator is that the device generates a narrow stream of high-frequency current, which strongly heats the biological tissue. When the current power reaches certain levels, at the point of contact, the tissue fluid is heated to such an extent that it turns into steam and breaks the surface of the tissue. At such a high temperature, local folding of proteins begins – coagulation. It is with this method that surgeons make the same bloodless incision in the tissues.
Under the influence of a diathermocoagulator, a kind of thrombus is formed in the damaged vessel. After contact with a high-frequency current, the inner and middle shells of the vessel fold and clog its lumen. Thus, you can quickly stop the flow of blood and relieve pain at the site of injury. It is this feature of the diathermocoagulator that makes it indispensable in surgery.
The use of the instrument requires high professionalism from the doctor performing the manipulations. The fact is that during the procedure it is extremely important to invest in certain time frames and correctly determine the power of the electric current. If diathermocoagulation is carried out for too long or at overestimated electric current, there is a serious risk for the vascular system and internal organs. An incorrectly performed procedure can disrupt metabolic processes and cause many severe adverse reactions.
When to use
The first indication for the use of a diathermocoagulator is to prevent or stop heavy bleeding, so the device is most often used in surgical practice. The dissection of tissues with the help of this device is not accompanied by a large loss of blood, since already during the incision, the vessels are instantly clogged.
However, coagulation is useful for more than just stopping bleeding. It well stimulates the regeneration of damaged tissues, stops inflammatory processes. For this reason, a diathermocoagulator is a fairly popular device in various branches of medicine. The range of its application is very wide. The device is used in gynecology, laparoscopy, dermatology, endoscopy, urology, dentistry, ophthalmology and, of course, surgery.
In gynecology, for example, it helps treat cervical erosion. In ophthalmology, it is perhaps the only effective method for the treatment of retinal detachments. In dentistry, it prevents hyperplasia of the papillary tissues of the gums, and is also effective in inflammation of the pulp. Dentists use this device during manipulations in root canals, in particular for coagulation in pulpitis and periodontitis. With the help of diathermocoagulation, small benign neoplasms on the mucous membranes of the oral cavity are removed, for example, papillomas, fibromas, hemangiomas, epulis. In addition, the high-frequency current of the diathermocoagulator is used to remove granulation tissue from the gingival canals.
The diathermocoagulator is also often used in cosmetology clinics and SPA salons. In particular, with the help of the device, keratomas, papillomas, moles (nevi), vulgar (common) warts, telangiectasia (spider veins), botryomycomes, atheromas (skin cyst) and even unwanted body hair are removed. For epilation, a very thin needle nozzle is used, which is injected into the hair follicle. After such exposure, the bulb collapses and the hair dies. To eliminate spider veins with a thin nozzle of a diathermocoagulator, the vessel is first “melted”, and then it is “soldered” without sealing.
Nowadays, the practice of using diathermocoagulation as part of complex treatment, combining it with drug therapy and physiotherapy, is quite common.
What is dangerous diathemocoagulator
The diathermocoagulator has many advantages, and with its appearance, the possibilities of medicine have significantly expanded. But at the same time, the device cannot be called completely safe for the human body, and procedures carried out with its help can sometimes cause side effects.
One of the first disadvantages of a diathermocoagulator (or, more correctly, side effects) is the formation of colloidal scars. An excessive amount of scar tissue for the body can be unsafe, as sometimes scars cause disruption of organs or entire systems. An example is a common clinical case – the treatment of cervical erosion with a diathermocoagulator. After the procedure, rather rough scars appear on the walls of the organ, which in turn leads to a narrowing of the lumen of the cervix. And this can cause multiple ruptures during the birth process. Therefore, the treatment of erosion by diathermocoagulation is not carried out in nulliparous women. In addition, the impact of a diathermocoagulator on the organs of the male or female reproductive system carries a certain risk in the form of impaired fertility.
If a large area of tissue was damaged during diathermocoagulation, the risk of patient infection increases. The consequence of infection is a longer recovery and rehabilitation time after the procedure. Improper use of a diathermocoagulator can cause burns or secondary bleeding on the patient’s body.
Terms of Use and Warnings
Diathermocoagulation for the treatment of gynecological problems is not done for pregnant women and women who have recently given birth. In addition, any methods of treatment using electric current are strictly prohibited for people with cancer, as well as for people with neoplasms of uncertain etiology. The diathermocoagulator is not used to stop bleeding from large vessels, and the device does not act on areas that are in close proximity to them or to nerve endings.
Diathermocoagulation as a cosmetic procedure is easier and with a minimum of side effects, meanwhile, some prohibitions and rules also exist. In particular, it is forbidden to wet the treated surface for 3 days, and for 2 weeks sunbathing and visits to the pool, sauna or bath are prohibited. The resulting crust in the places of exposure to the device can not be removed. It is also not allowed to seal the treated areas with adhesive tape or wipe them with alcohol-containing agents.
How is the procedure performed
Before deciding on diathermocoagulation, it is necessary to carefully analyze all the advantages and dangers of the procedure for the patient. If there are no contraindications and the use of a diathermocoagulator is justified, then the treatment session can be carried out using one of the methods described below.
There are two main methods of working with a diathermocoagulator: monopolar and bipolar. In the first case, the procedure is carried out using only one electrode, in the second – using two. In addition, the bipolar method of exposure can be monoactive or biactive. The monoactive method of diathermocoagulation consists in the use of two electrodes of different sizes: large (passive) and small (active). The procedure according to the biactive method is also done using two electrodes, but both of them are small and located close to each other. Regardless of what type of procedure is performed by the device – incision or coagulation – the power of the voltage supplied to the electrodes is increased gradually.
In medical practice, most often they resort to diathermocoagulation, carried out by a bipolar monoactive method. As already mentioned, two electrodes are involved during the procedure: active and passive. Passive (the one that is larger) is placed on the lumbar region of the patient, active – on the area being exposed. On average, a diathermocoagulation session lasts about 2 hours. During this time, with the help of an active electrode, a certain area is repeatedly exposed to high-frequency electric current. The one-time period of direct contact between the electrode and the tissue is from 5 to 12 seconds. In order to stop bleeding, the vessel is held with tweezers and touched with an active electrode. The same method affects papillomas or warts, treats some diseases of the digestive tract, rectum, throat, ulcerative formations on the walls of the bladder. Depending on the type of tissue and the area of the affected area, the session can be carried out using active electrodes of various shapes and sizes.
The healing time of the tissue after the procedure depends on many factors. In most cases, the recovery process lasts from 4 to 10 weeks. If diathermocoagulation was used to treat cervical erosion, the recovery time can be delayed up to 6 months, during which the woman may experience spotting. During the entire period of rehabilitation, the patient should regularly undergo examinations by the attending physician.
The diathermocoagulator is a multifunctional device. With its help, both heavy surgical operations are carried out, as well as many lighter procedures offered by most beauty salons. But it is up to a qualified specialist to decide whether diathermocoagulation is necessary and, most importantly, whether diathermocoagulation is allowed for the patient.