New NHS guidance has been published supporting the use of an innovative electrosurgical device to reduce the risk of localised burns during surgery.
The National Institute for Health and Clinical Excellence (NICE) advises surgeons to use the Mega Soft Patient Return Electrode during monopolar electrosurgery.
Traditionally, during the majority of open surgery procedures, clinicians use a tool with an electric current running through it to cauterise incisions and reduce bleeding while cutting fine blood vessels. Due to this electric current, the patient becomes part of a circuit, so the current needs to flow back to the generator to complete the circuit. In current NHS practice, the current leaves the patient via a disposable, single-use patient return electrode, which is attached directly to the patient’s skin via a ‘sticky surface’, usually a pad. The Mega Soft Patient Return Electrode, from Megadyne, is instead incorporated into a padded layer on which the patient lies during surgery. It is claimed that, as well as reducing burns that can occur with disposable single-use diathermy pads, it also relieves pressure.
The NICE guidance advises that the Mega Soft Patient Return Electrode may offer particular advantages for selected patients, such as those who would require shaving for application of disposable electrode pads and those with fragile or damaged skin. In addition, the device may benefit operating theatre staff in terms of increased convenience and reduced setting up time. The economic considerations show that cost/resource requirements are similar to current practice. However, expert advice suggests the resource consequences of the Mega Soft Patient Return Electrode are greatly influenced by the circumstances in which it is used.
NICE medical technology guidance helps to enable new medical technologies, or innovative modifications to existing ones, to be used more quickly and consistently in the NHS across England. The guidance, produced by the independent Medical Technologies Advisory Committee (MTAC), concludes that it is plausible that the Mega Soft Patient Return Electrode reduces the risk of burns related to the diathermy patient return electrode where surgery is carried out in the context of good operating theatre practice.
This final guidance for the Mega Soft Patient Return Electrode shows that, if used for carefully selected patients, the device could provide benefits in reducing burns resulting from electrosurgery
Professor Carole Longson, director of the NICE Centre for Health Technology Evaluation, said: “This final guidance for the Mega Soft Patient Return Electrode shows that, if used for carefully selected patients, the device could provide benefits in reducing burns resulting from electrosurgery. There are also possible benefits for theatre staff in terms of convenience and reduced setting up time; which are more likely to be seen for inpatient operating lists than for day case surgery.
The recommendations also note that clinicians and managers judging the likely benefits of adopting the device should take into account current practice in their operating theatres, including the proportion of inpatient operations for which it would be used.
Professor Longson added: “Rather than advising widespread adoption for all patients, the recommendations have focused on those patient groups who are likely to gain most benefit. We hope the guidance will be useful for hospital staff who may be considering how to reduce risk of burns arising from monopolar electrosurgery.”For the full guidance, click here
