SURGICAL DIATHERMY

SURGICAL diathermy, or endothermy, is a method of destruction depending in major part upon the localized production of heat generated by the resistance of tissue to the passage of a high frequency electrical current, which produces a violent agitation of molecules. Medical diathermy is characterized by the stimulating action of heat so produced, whereas surgical diathermy is distinguished by the destructive action of such heat.

            In accordance with the type and strength of the current, and the method of application, a variety of tissue effects are manifested. Fulguration is destruction by flashing. The monoterminal Oudin current is applied by means of a pointed electrode that is held at a distance from the skin, causing the sparks to jump through the air to the tissue. Electrodesiccation is the use of a similar current applied by means of a needle which is inserted into the skin before the current is turned on. The current is turned off before the needle is withdrawn, no sparking being permitted. Electro-coagulation is tissue coagulation by the use of the biterminal d'Arsonval current with one active needle electrode and one dispersing large metal electrode placed as near the part to be treated as possible. It is an intense, penetrative and rapid process by which the tissues become devitalized to an amorphous necrotic mass. Carbonization (charring ) is the reduction of the tissue into a residue of carbon. Searing is a general term applied to the edges of tissues treated with cutting currents, and comprehends any of the preceding degrees of destruction. Brushing is when the cutting current is used as a monopolar current without the indifferent electrode for searing the surface. This is specially useful in the treatment of moles.