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Electrofulguration

Electrical arcs are used in many aspects of our lives. They are sometimes referred to as plasma for marketing purposes.

Devices generating an electrical arc have been used in the operating theatres since the early 20th century. The first electrosurgical unit, also known as the Bovie Generator, is credited to William T. Bovie while he was working at Harvard University. The first use of an electrosurgical generator in an operating theatre was on October 1, 1926 at the Peter Bent Brigham Hospital in Boston, Massachusetts, in the USA.

The first operation is believed to have been performed by Dr Harvey Cushing an american neurosurgeon. Ever since, due to its versatility, the use of electrofulguration or electrodesiccation have expanded worldwide. Later thanks to the increasing availability of voltaic arc generators, the practice has extended to aesthetic uses.

The voltage used by surgical and aesthetic equipment ranges between the 500–10,000 Volts peak-to-peak and are capable of injecting high currents through the body and through its surface, depending on how they are used. So, how is it possible that these sparks, at times injecting high currents, can travel through our bodies without causing any harm?

We have all experienced mild electric shock by an accidental contact with a live wire in our houses, and we know the unpleasant it can be. So how is the same electrical power used safely?

If we were to use the same peak to peak voltage of 50Hz as found in domestic supply, we would experience an electric shock. The magic is in the operational frequency of the device. The frequency output generated by these devices starts from 50 KHz (note this is 50,000Hz not 50Hz). This higher frequency avoids the undesired electro muscular stimulation, which in turn avoids electric shocks. Because of this principle, electrical surgical devices have high currents at high voltage (therefore high power) and can thus be put through the human body without any harm either to the internal organs or nervous system. Remember that the first elecro-surgical unit was used by a neurosurgeon, and gives idea of the level of confidence and inherent safety of such devices. Thanks to this, these devices have been in widespread use in the medical and esthetic world since the 1930s.

Today the use of voltaic arcs in medicine include:

  • Electrocoagulation, meaning coagulating blood vessels in which require to blood flow has to be stopped (hemostasis).
  • The destruction of soft tissues – including but not limited to removal of tumours (ablation).
  • The cutting of a variety of tissues in the operating theatre;

Additionally in aesthetics electrical arcs with high frequency currents have applications in:

  • Skin tightening;
  • The removal of benign moles and benign skin lesions;
  • Tattoo removal
  • Red vein cauterisation