Hyfrecator
Encyclopedia
A hyfrecator is a low-powered medical apparatus used in electrosurgery
on conscious patients, usually in an office setting. It is used to destroy tissue directly, and to stop bleeding during minor surgery. It works by emitting low-power high-frequency A.C. electrical pulses, via an electrode mounted on a handpiece, directly to the affected area of the body. The amount of output power is adjustable, and the device is equipped with different tips, electrodes and forceps
, depending on the electrosurgical requirement.
The word Hyfrecator® is a portmanteau brandname derived from “high-frequency eradicator.” The device was originally introduced with this name in 1940, by the Birtcher Corporation of Los Angeles. However, a number of manufacturers now produce "Hyfrecators". The name "hyfrecator" has since come to be used generically (like the once- tradenamed "aspirin
") to refer to any dedicated non-ground-return electrosurgical apparatus.
providing a current sink (this is equivalent to considering displacement current
to be the return current).
In the latter mode, the patient must sit or lie on an insulated table, much as in the case with objects to be charged electrostatically with high-voltage D.C. (as from a Van de Graaff generator
, for example). Stray ground paths between the patient and foreign conductors (such as a metal table leading somewhere to earth-ground) can offer another capacitative reservoir besides the patient, and burns may thus result from current passing between patient and the earth-ground. For this reason, hyfrecation and all non-ground-pad electrosurgery is performed only on conscious patients who would be aware of the burn and discomfort from an unwanted earth-ground path. (In types of electrosurgery which do employ a ground pad, the ground-pad path serves as such a low resistance ground to the machine that extraneous other paths become unimportant, and so with proper precautions these methods can, and often are, used on anesthetized patients).
Because hyfrecation is a low-power modality, it can be used in some situations (such as very small nevus
removal or skin tag removal) without local anaesthesia. In many other uses to destroy larger lesions, a local anesthetic injection or regional nerve block is used. The pain from hyfrecation is due to the burning of tissue, and the pain of electrical current is absent, due to the high (radio) frequency which does not affect discharge of nerves.
Although the hyfrecator is not used primarily to cut tissue, it may be used in a secondary capacity to control bleeding, after tissue is cut by a standard surgical scalpel, under local anesthesia. An example is the standard method of electrodesiccation and curettage used by dermatologists to destroy skin cancers.
Electrosurgery
Electrosurgery is the application of a high-frequency electric current to biological tissue as a means to cut, coagulate, desiccate, or fulgurate tissue. . Its benefits include the ability to make precise cuts with limited blood loss...
on conscious patients, usually in an office setting. It is used to destroy tissue directly, and to stop bleeding during minor surgery. It works by emitting low-power high-frequency A.C. electrical pulses, via an electrode mounted on a handpiece, directly to the affected area of the body. The amount of output power is adjustable, and the device is equipped with different tips, electrodes and forceps
Forceps
Forceps or forcipes are a handheld, hinged instrument used for grasping and holding objects. Forceps are used when fingers are too large to grasp small objects or when many objects need to be held at one time while the hands are used to perform a task. The term 'forceps' is used almost exclusively...
, depending on the electrosurgical requirement.
The word Hyfrecator® is a portmanteau brandname derived from “high-frequency eradicator.” The device was originally introduced with this name in 1940, by the Birtcher Corporation of Los Angeles. However, a number of manufacturers now produce "Hyfrecators". The name "hyfrecator" has since come to be used generically (like the once- tradenamed "aspirin
Aspirin
Aspirin , also known as acetylsalicylic acid , is a salicylate drug, often used as an analgesic to relieve minor aches and pains, as an antipyretic to reduce fever, and as an anti-inflammatory medication. It was discovered by Arthur Eichengrun, a chemist with the German company Bayer...
") to refer to any dedicated non-ground-return electrosurgical apparatus.
Differentiation from other types of electrosurgical equipment
The hyfrecator differs from other electrosurgical devices primarily in being low-powered and not intended for cutting tissue, or for use in other than conscious patients. The reason is that the hyfrecator does not use a dispersive return pad or "patient plate", and thus either passes a very low-powered current between forceps tips (bipolar output), or else between a single pointed metal electrode probe, and the patient, with only the patient's self-capacitanceCapacitance
In electromagnetism and electronics, capacitance is the ability of a capacitor to store energy in an electric field. Capacitance is also a measure of the amount of electric potential energy stored for a given electric potential. A common form of energy storage device is a parallel-plate capacitor...
providing a current sink (this is equivalent to considering displacement current
Displacement current
In electromagnetism, displacement current is a quantity that is defined in terms of the rate of change of electric displacement field. Displacement current has the units of electric current density, and it has an associated magnetic field just as actual currents do. However it is not an electric...
to be the return current).
In the latter mode, the patient must sit or lie on an insulated table, much as in the case with objects to be charged electrostatically with high-voltage D.C. (as from a Van de Graaff generator
Van de Graaff generator
A Van de Graaff generator is an electrostatic generator which uses a moving belt to accumulate very high voltages on a hollow metal globe on the top of the stand. It was invented in 1929 by American physicist Robert J. Van de Graaff. The potential differences achieved in modern Van de Graaff...
, for example). Stray ground paths between the patient and foreign conductors (such as a metal table leading somewhere to earth-ground) can offer another capacitative reservoir besides the patient, and burns may thus result from current passing between patient and the earth-ground. For this reason, hyfrecation and all non-ground-pad electrosurgery is performed only on conscious patients who would be aware of the burn and discomfort from an unwanted earth-ground path. (In types of electrosurgery which do employ a ground pad, the ground-pad path serves as such a low resistance ground to the machine that extraneous other paths become unimportant, and so with proper precautions these methods can, and often are, used on anesthetized patients).
Because hyfrecation is a low-power modality, it can be used in some situations (such as very small nevus
Nevus
Nevus is the medical term for sharply-circumscribed and chronic lesions of the skin. These lesions are commonly named birthmarks and moles. Nevi are benign by definition...
removal or skin tag removal) without local anaesthesia. In many other uses to destroy larger lesions, a local anesthetic injection or regional nerve block is used. The pain from hyfrecation is due to the burning of tissue, and the pain of electrical current is absent, due to the high (radio) frequency which does not affect discharge of nerves.
Although the hyfrecator is not used primarily to cut tissue, it may be used in a secondary capacity to control bleeding, after tissue is cut by a standard surgical scalpel, under local anesthesia. An example is the standard method of electrodesiccation and curettage used by dermatologists to destroy skin cancers.
Modes of use
Hyfrecators are used in two principal modes:- DesiccationDesiccationDesiccation is the state of extreme dryness, or the process of extreme drying. A desiccant is a hygroscopic substance that induces or sustains such a state in its local vicinity in a moderately sealed container.-Science:...
, in which electrical energy kills tissue near the probe tip by heating it past the temperature at which cells can survive. The method is called desiccation because it removes water from tissue as steam, leaving the tissue white and dead, without obviously being burned. This mode is usually employed with the probe in physical contact with the skin or lesion to be destroyed. This method is notable for causing relatively little actual destruction at the point of skin contact, but a large zone of destruction beneath the skin, as the current from the probe fans out into the tissue below the point of contact. Such effects may be deliberately employed in destruction of subcutaneous nodules, where minimal damage to the intact and normal skin surface is desired, at the same time as destruction and degeneration of a larger mass immediately beneath the skin, such as a subcutaneous wart or sebaceous gland.
- FulgurationFulgurationFulguration, also called electrofulguration, is a procedure to destroy tissue using a high-frequency electric current applied with a needlelike electrode.- External links :...
, in which a deliberate spark is generated by touching or nearly touching the sharp probe to the lesion or skin. This results in far higher temperatures at the point of contact of the spark to skin, causing very high temperatures and carbonization (eschar) of the tissue immediately at the spark-contact point, and just below it. Thus, it results in the highest effect at the point of spark contact. This is most useful for completely destroying very superficial structures, such as nevi and skin tags, which protrude above the skin surface.
Targets of use
- The hyfrecator has a large number of uses, such as removal of wartWartA wart is generally a small, rough growth, typically on a human’s hands or feet but often other locations, that can resemble a cauliflower or a solid blister. They are caused by a viral infection, specifically by human papillomavirus 2 and 7. There are as many as 10 varieties of warts, the most...
s, pearly penile papulesHirsuties papillaris genitalisHirsuties coronae glandis are small saliences on the ridge of the glans of the male genital organs. It is a harmless anatomical variation. They are found significantly more often on uncircumcised men, and on younger men...
, desiccationDesiccationDesiccation is the state of extreme dryness, or the process of extreme drying. A desiccant is a hygroscopic substance that induces or sustains such a state in its local vicinity in a moderately sealed container.-Science:...
of sebaceous glandSebaceous glandThe sebaceous glands are microscopic glands in the skin that secrete an oily/waxy matter, called sebum, to lubricate and waterproof the skin and hair of mammals...
disorders, electrocautery of bleeding, epilationEPilationEPilation is the first full-length release from Brisbane musician Tara Simmons. Although a full-length, EPilation contains no new material and is a compilation of Tara's first two EPs Pendulum and All The Amendments...
, destruction of small cosmetically unwanted superficial veins, in certain types of plastic surgeryPlastic surgeryPlastic surgery is a medical specialty concerned with the correction or restoration of form and function. Though cosmetic or aesthetic surgery is the best-known kind of plastic surgery, most plastic surgery is not cosmetic: plastic surgery includes many types of reconstructive surgery, hand...
, and many other dermatologicalDermatologyDermatology is the branch of medicine dealing with the skin and its diseases, a unique specialty with both medical and surgical aspects. A dermatologist takes care of diseases, in the widest sense, and some cosmetic problems of the skin, scalp, hair, and nails....
tasks. It may also be instrumental in the destruction of skin cancerCancerCancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
s such as basal cell carcinomaBasal cell carcinomaBasal-cell carcinoma is the most common type of skin cancer. It rarely metastasizes or kills. However, because it can cause significant destruction and disfigurement by invading surrounding tissues, it is still considered malignant. Statistically, approximately 3 out of 10 Caucasians may develop a...
. For larger amounts of tissue destruction, the hyfrecator may be used in multiple sessions in the same area or point, as for example to gradually reduce the size of a large subcutaneous structure, such as a plantar wart.
- The hyfrecator is useful to control bleeding in dermatological office surgery in conscious patients, after tissue-cutting, tissue removal, or biopsy is first done mechanically, with a scalpelScalpelA scalpel, or lancet, is a small and extremely sharp bladed instrument used for surgery, anatomical dissection, and various arts and crafts . Scalpels may be single-use disposable or re-usable. Re-usable scalpels can have attached, resharpenable blades or, more commonly, non-attached, replaceable...
. See electrodesiccation and curettage.
- The hyfrecator can be used in almost all fields of medicine, e.g. chiropody, dentistryDentistryDentistry is the branch of medicine that is involved in the study, diagnosis, prevention, and treatment of diseases, disorders and conditions of the oral cavity, maxillofacial area and the adjacent and associated structures and their impact on the human body. Dentistry is widely considered...
, ophthalmologyOphthalmologyOphthalmology is the branch of medicine that deals with the anatomy, physiology and diseases of the eye. An ophthalmologist is a specialist in medical and surgical eye problems...
, gynecology, and veterinary medicineVeterinary medicineVeterinary Medicine is the branch of science that deals with the prevention, diagnosis and treatment of disease, disorder and injury in non-human animals...
.
- More recently, the hyfrecator is being used by those performing body modification services as a more precise way to brand the skin for aesthetic purposes. It allows more intricate and elaborate designs to be burned into the skin.
External links
- Hyfrecator on ConMed site
- "The hyfrecator: a treatment for radiation induced telangiectasia in breast cancer patients" -- British Journal of Radiology
- "Comparison of potassium titanyl phosphate vascular laser and hyfrecator in the treatment of vascular spiders and cherry angiomas." (Abstract) - Clinical and experimental dermatology
- http://www.pearlypenilepapules.co.uk