Physics-based studies of surgical electrode design to prevent sparking enhanced skin burns during electrocautery

Abstract

Proper care and handling of electrosurgical equipment are essential to patient and personnel safety. Burns that destroy layers of the patient’s skin often linked to a medical mistake are largely preventable. This paper is dealing with the design of surgical electrodes as one of the extremely important factors for the formation of burns during standard procedures. Simulations have been performed by using the COMSOL simulation package for various electrode configurations (cylinder-cylinder, sphere-sphere, cylinder-sphere, cylinder-cone, sphere-cone, and cone-cone) representing shapes of surgical electrodes. The primary goal was to determine the location and the voltage required for sparking. The obtained simulation results agree well with the experimental data taken from literature revealing that the sparking formation is strongly affected by the electrode configuration. Sparking occurs most easily when both electrodes are cylindrical and the most difficult when one electrode is a cone. It was also found that the sparking mechanism is not the same in both directions between the active electrode and passive metal plate due to electrical asymmetries. Electrical asymmetries may lead to differences in breakdown voltage even to 40%. Since the asymmetry is the cause of undesirable direct current burns and neuromuscular electrostimulation, and the conformity process does not take into account the sparking phenomena, the certification process for this class of equipment must change. Results presented here can be used to establish practices for the safe use of the electrocautery device and to prevent injury to patients and staff.