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 high-voltage AC electrical pulses, via an electrode mounted on a handpiece, directly to the affected area of the body. A continuous electric spark discharge may be drawn between probe and tissue, especially at the highest settings of power, although this is not necessary for the device to function. The amount of output power is adjustable, and the device is equipped with different tips, electrodes and forceps, depending on the electrosurgical requirement. Unlike other types of electrosurgery, the hyfrecator does not employ a dispersive electrode pad that is attached to the patient in an area not being treated, and that leads back to the apparatus (sometimes loosely but not quite correctly called a "ground pad"). It is designed to work with non-grounded (insulated) patients.
The word hyfrecator is a portmanteau derived from “high-frequency eradicator.” It was introduced as a brand name for a device introduced in 1940 by the Birtcher Corporation of Los Angeles. [1] Birtcher also trademark registered the name Hyfrecator in 1939, and rights to the registered trademark were acquired by CONMED Corporation when it acquired Birtcher in 1995. [2] [3] Today, machines with the name Hyfrecator are sold only by ConMed Corporation. However, the word "hyfrecator" is sometimes used as a genericized trademark to refer to any dedicated non-ground-return electrosurgical apparatus, and a number of manufacturers now produce such machines, although not by this name.
The hyfrecator primarily differs from other electrosurgical devices in that it is low-powered and not intended for cutting tissue, thus enabling its use with conscious patients. The hyfrecator does not require a dispersive return pad, referred-to in the electrosurgery field as a "ground pad," or "patient plate," because the hyfrecator can pass a very low-powered current between forceps tips via bipolar output, or pass an A.C. current between one pointed metal electrode probe and the patient, with the patient's self-capacitance alone 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 out of the area of treatment 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 ground paths become unimportant, and thus with proper precautions these methods can, and often are, used on anesthetized patients).
Because hyfrecation is always a relatively 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 electric current is absent, due to the high (radio) frequency which does not directly cause 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, or else it may be used to partly destroy superficial tissue, that is then removed by the scraping action of a curette. These are done under local anesthesia. An example of such a combination procedure is the standard method of electrodesiccation and curettage used by dermatologists to destroy skin cancers.
Hyfrecators are used in two principal modes:
Cauterization is a medical practice or technique of burning a part of a body to remove or close off a part of it. It destroys some tissue in an attempt to mitigate bleeding and damage, remove an undesired growth, or minimize other potential medical harm, such as infections when antibiotics are unavailable.
Laser hair removal is the process of hair removal by means of exposure to pulses of laser light that destroy the hair follicle. It had been performed experimentally for about twenty years before becoming commercially available in 1995–1996. One of the first published articles describing laser hair removal was authored by the group at Massachusetts General Hospital in 1998. Laser hair removal is widely practiced in clinics, and even in homes using devices designed and priced for consumer self-treatment. Many reviews of laser hair removal methods, safety, and efficacy have been published in the dermatology literature.
Diathermy is electrically induced heat or the use of high-frequency electromagnetic currents as a form of physical therapy and in surgical procedures. The earliest observations on the reactions of the human organism to high-frequency electromagnetic currents were made by Jacques Arsene d'Arsonval. The field was pioneered in 1907 by German physician Karl Franz Nagelschmidt, who coined the term diathermy from the Greek words διά dia and θέρμη thermē, literally meaning "heating through".
Calcinosis cutis is an uncommon condition marked by calcium buildup in the skin and subcutaneous tissues. Calcinosis cutis can range in intensity from little nodules in one area of the body to huge, crippling lesions affecting a vast portion of the body. Five kinds of the condition are typically distinguished: calciphylaxis, idiopathic calcification, iatrogenic calcification, dystrophic calcification, and metastatic calcification.
Cryosurgery is the use of extreme cold in surgery to destroy abnormal or diseased tissue; thus, it is the surgical application of cryoablation. Cryosurgery has been historically used to treat a number of diseases and disorders, especially a variety of benign and malignant skin conditions.
Cherry angioma, also called cherry hemangioma or Campbell de Morgan Spot, is a small bright red dome-shaped bump on the skin. It ranges between 0.5 – 6 mm in diameter and usually several are present, typically on the chest and arms, and increasing in number with age. If scratched, they may bleed.
Radiofrequency ablation (RFA), also called fulguration, is a medical procedure in which part of the electrical conduction system of the heart, tumor or other dysfunctional tissue is ablated using the heat generated from medium frequency alternating current. RFA is generally conducted in the outpatient setting, using either local anesthetics or twilight anesthesia. When it is delivered via catheter, it is called radiofrequency catheter ablation.
Electrosurgery is the application of a high-frequency alternating polarity, electrical 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. Electrosurgical devices are frequently used during surgical operations helping to prevent blood loss in hospital operating rooms or in outpatient procedures.
Endometrial ablation is a surgical procedure that is used to remove (ablate) or destroy the endometrial lining of the uterus. The goal of the procedure is to decrease the amount of blood loss during menstrual periods. Endometrial ablation is most often employed in people with excessive menstrual bleeding, who do not wish to undergo a hysterectomy, following unsuccessful medical therapy.
A pyogenic granuloma or lobular capillary hemangioma is a vascular tumor that occurs on both mucosa and skin, and appears as an overgrowth of tissue due to irritation, physical trauma, or hormonal factors. It is often found to involve the gums, skin, or nasal septum, and has also been found far from the head, such as in the thigh.
Somnoplasty is a trademark by Somnus Medical Technologies used for its radiofrequency ablation medical devices cleared by the Food and Drug Administration (FDA) to treat habitual snoring, chronic nasal obstruction, and obstructive sleep apnea (OSA) to shrink the tissues that are causing obstruction. Somnoplasty is typically an outpatient procedure that takes 30–45 minutes.
Gingivectomy is a dental procedure in which a dentist or oral surgeon cuts away part of the gums in the mouth.
A gum lift is a cosmetic dental procedure that raises and sculpts the gum line. This procedure involves reshaping the tissue and/or underlying bones to create the appearance of longer or symmetrical teeth, thereby making the smile more aesthetically pleasing. This procedure is typically done to reduce excessively gummy smiles or to balance out an asymmetrical gum line. The procedure, also known as crown-lengthening, has historically been used to treat gum disease. It is only within the past three to five years that dentists have commonly used this procedure for aesthetic purposes. The practice of cosmetic gum lifts was first developed in the late 1980s, but there were few oral surgeons and dental practitioners available to perform the procedures. Gum lifts can also include bone shaping to reduce the prominence of the upper jaw and even out the tooth and gum ratio. This method provides permanent results, while simple gum contouring may result in relapse or regrowth of the gingiva.
Periungual warts are warts that cluster around the fingernail or toenail. They appear as thickened, fissured cauliflower-like skin around the nail plate. Periungual warts often cause loss of the cuticle and paronychia. Nail biting increases susceptibility to these warts.
Poromas are rare, benign, cutaneous adnexal tumors. Cutaneous adnexal tumors are a group of skin tumors consisting of tissues that have differentiated towards one or more of the four primary adnexal structures found in normal skin: hair follicles, sebaceous sweat glands, apocrine sweat glands, and eccrine sweat glands. Poromas are eccrine or apocrine sweat gland tumors derived from the cells in the terminal portion of these glands' ducts. This part of the sweat gland duct is termed the acrosyringium and had led to grouping poromas in the acrospiroma class of skin tumors. Here, poromas are regarded as distinct sweat gland tumors that differ from other sweat gland tumors by their characteristic clinical presentations, microscopic histopathology, and the genetic mutations that their neoplastic cells have recently been found to carry.
Electrodesiccation and curettage is a medical procedure commonly performed by dermatologists, surgeons and general practitioners for the treatment of basal cell cancers and squamous cell cancers of the skin. It provides desiccation, coagulation/cauterization, and curettage to remove lesions from the skin.
Plasma medicine is an emerging field that combines plasma physics, life sciences and clinical medicine. It is being studied in disinfection, healing, and cancer. Most of the research is in vitro and in animal models.
Stasis papillomatosis is a disease characterized by chronic congestion of the extremities, with blood circulation interrupted in a specific area of the body. A consequence of this congestion and inflammation is long-term lymphatic obstruction. It is also typically characterized by the appearance of numerous papules. Injuries can range from small to large plates composed of brown or pink, smooth or hyperkeratotic papules. The most typical areas where injuries occur are the back of the feet, the toes, the legs, and the area around a venous ulcer formed in the extremities, although the latter is the rarest of all. These injuries include pachydermia, lymphedema, lymphomastic verrucosis and elephantosis verrucosa. The disease can be either localized or generalized; the localized form makes up 78% of cases. Treatment includes surgical and pharmaceutical intervention; indications for partial removal include advanced fibrotic lymphedema and elephantiasis. Despite the existence of these treatments, chronic venous edema, which is a derivation of stasis papillomatosis, is only partially reversible. The skin is also affected and its partial removal may mean that the skin and the subcutaneous tissue are excised. A side effect of the procedure is the destruction of existing cutaneous lymphatic vessels. It also risks papillomatosis, skin necrosis and edema exacerbation.
Plasma Surgical is a privately held medical device company with headquarters in suburban Atlanta, Georgia, USA, with operations in the UK and France. The company was founded based on the work of plasma physics professor Nikolay Suslov, who developed a technology to apply plasma energy to surgically treat live tissue with minimal thermal damage.
Medical applications of radio frequency (RF) energy, in the form of electromagnetic waves or electrical currents, have existed for over 125 years, and now include diathermy, hyperthermy treatment of cancer, electrosurgery scalpels used to cut and cauterize in operations, and radiofrequency ablation. Magnetic resonance imaging (MRI) uses radio frequency waves to generate images of the human body.