Electrosurgical unit: Iatrogenic injuries and medico-legal aspect. Italian legal rules, experience and article review. (February 2021)

• Record Type: Journal Article
• Authors: Gualniera, Patrizia; Scurria, Serena; Sapienza, Daniela; Asmundo, Alessio
• Is Part Of: Annals of medicine and surgery. Volume 62(2021)
• Page Start: 26
• Page End: 30
• Publication Date: 2021-02
• Subjects: Electrosurgical injury -- Professional liability; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2020.12.031
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Background: The use of the electrosurgical unit (ESU) is well-established in the surgical practice. The Authors, to better understand the genesis of injuries connected to the use of electrosurgical instruments, conducted an in-depth literature review pertaining to this topic. Materials and method: Using the most important medical databases, a research of experimental studies in the last 20 years was conducted. Results: The analysis of the mechanisms responsible for the lesions showed that high energy devices remain as the most common cause of injury. Adverse events are mainly given by thermal injuries; cases of electromagnetic interference are also described in patients with pacemakers or sacral nerve stimulator and spinal stimulators as well as cases of fire of the endotracheal tube in the course of tracheostomy for the use of the electrosurgical unit in an environment with a high concentration of oxygen or anesthetic gases. Also reported in the literature are individual cases of fires caused by sparks from the electrosurgical handpiece also for the use of disinfectants and/or in relation to surgical drapes. Conclusion: In order to clearly define the medical-legal aspects, focusing on the professional responsibility of the surgical and nursing staff, the authors' attention was brought to the need for an effective prevention plan that highlights not only the importance of an accurate procedural knowledge in order to safety use the electrosurgical instruments, but also the need for a system that monitors any complications or adverse events resulting from the use of such instruments. Highlights: The use of the electrosurgical unit (ESU) is consolidated in surgical practice. Adverse events are mostly represented in electrosurgery. Literature in last 20 years describe than 5256 article with topic about iatrogenic damage in electrosurgery damage. Medico-legal features are important for the assessment of health workers liability. Improve prevention systems is the best solving in order to limit iatrogenic damage and consequently possible claims.