1. What is radiofrequency cauterisation/ ablation?
Radio frequency ablation is a versatile Dermatosurgical procedure used for surgical management of skin lesions by using various forms of alternating current at an ultra-high frequency. The major modalities in radiofrequency are electrocoagulation, electrodessication and fulguration. The use of radiofrequency ablation in Dermatosurgical practice has gained importance in recent years as it can be used to treat most of the skin lesions with ease in less time with clean surgical field due to adequate Haemostasis and with minimal side effects and complications.
2. What are the Dermatological Indications of RFA?
a). Diagnostic: Skin biopsy, excision of cysts and abscesses.
b). Infections: Verrucae, Pyogenic Granuloma and Molluscum Contagiosum.
c). Metabolic: Xanthelasma, Xanthomas.
d). Benign skin conditions: Freckles, dermatitis papulosa nigra, acne, skin tags, cherry angiomas, spider angiomas, naevi, trichoepithelioma, syringomas, apocrine hidrocystomas, stucco keratosis, papilloma, neurofibromas, cutaneous horn, keratocanthoma, rhinophyma, sebaceous hyperplasia and keloids.
e). Senile skin conditions: Actinic keratosis, sebborheic keratosis and senile lentigenes.
f). Malignant skin tumours: Squamous cell carcinoma, basal cell carcinoma, dermatofibroma sarcoma protuberans and carcinoma in situ lesions of the skin and orogenital mucosa.
g). Nail procedures: Nail matrixectomies, surgical hemostasis of ingrown toenail and onychogryphosis.
h). Cosmetic indications: Mole removal, telangiectasia, unwanted hair removal, scar revision, ear-lobe repair, development of flaps, oculoplastic procedures and blepharoplasties.
3. Is it a painful procedure?
Local anaesthetic, i.e., lignocaine is administered before most radio surgical techniques. The use of lignocaine with epinephrine further reduces blood loss, but the use of epinephrine at the tips of digits and the nose should be avoided. Another alternative is to use a eutectic mixture of local anaesthetics (EMLA) cream that contains 2.5% lidocaine and 2.5% prilocaine. It is applied under occlusion to skin at least 1 h before the procedure to achieve topical anaesthesia. Anaesthesia may not be necessary for the electro surgery of small lesions such as telangiectasia’s and small skin tags.
4. What are the advantages of using radiofrequency ablation over other available methods?
RFA is a simple, safe procedure with wider applications. It causes less lateral heat spread and tissue damage and provides better control in comparison to electric cautery. The cutting mode of radiofrequency is more effective and versatile in comparison to the carbon dioxide laser. As haemostasis occurs simultaneously, the time required for the surgery is less. There are fewer side effects and complications. RFA can be easily combined with other surgical modalities such as Cryo Therapy and laser for treatment.
5. Any precautions to be considered for this procedure?
RFA should be avoided in unstable cardiac patients and in the treatment of the lesions of the skin overlying a pacemaker. Special care should be taken while performing radiosurgery near eye. RFA should not be done in presence of oxygen as there is risk of explosion. It should be made sure that patient is in contact with the ground plate during procedure. The operator should consider wearing a surgical mask and eye protection when working on lesions containing HPV.
6. Are there any Side Effects and Complications of using this procedure?
The common side effects that occur with radiofrequency are pain, tissue edema, bleeding, infection, post inflammatory hypo/hyper or depigmentation, scarring and keloid formation. The bacterial transference of Staphylococcus aureus through electrode from one patient to another is possible; however, it is much more possible during electrodessication than during electrocoagulation.
Radio frequency ablation is a versatile Dermatosurgical procedure used for surgical management of skin lesions by using various forms of alternating current at an ultra-high frequency. The major modalities in radiofrequency are electrocoagulation, electrodessication and fulguration. The use of radiofrequency ablation in Dermatosurgical practice has gained importance in recent years as it can be used to treat most of the skin lesions with ease in less time with clean surgical field due to adequate Haemostasis and with minimal side effects and complications.
2. What are the Dermatological Indications of RFA?
a). Diagnostic: Skin biopsy, excision of cysts and abscesses.
b). Infections: Verrucae, Pyogenic Granuloma and Molluscum Contagiosum.
c). Metabolic: Xanthelasma, Xanthomas.
d). Benign skin conditions: Freckles, dermatitis papulosa nigra, acne, skin tags, cherry angiomas, spider angiomas, naevi, trichoepithelioma, syringomas, apocrine hidrocystomas, stucco keratosis, papilloma, neurofibromas, cutaneous horn, keratocanthoma, rhinophyma, sebaceous hyperplasia and keloids.
e). Senile skin conditions: Actinic keratosis, sebborheic keratosis and senile lentigenes.
f). Malignant skin tumours: Squamous cell carcinoma, basal cell carcinoma, dermatofibroma sarcoma protuberans and carcinoma in situ lesions of the skin and orogenital mucosa.
g). Nail procedures: Nail matrixectomies, surgical hemostasis of ingrown toenail and onychogryphosis.
h). Cosmetic indications: Mole removal, telangiectasia, unwanted hair removal, scar revision, ear-lobe repair, development of flaps, oculoplastic procedures and blepharoplasties.
3. Is it a painful procedure?
Local anaesthetic, i.e., lignocaine is administered before most radio surgical techniques. The use of lignocaine with epinephrine further reduces blood loss, but the use of epinephrine at the tips of digits and the nose should be avoided. Another alternative is to use a eutectic mixture of local anaesthetics (EMLA) cream that contains 2.5% lidocaine and 2.5% prilocaine. It is applied under occlusion to skin at least 1 h before the procedure to achieve topical anaesthesia. Anaesthesia may not be necessary for the electro surgery of small lesions such as telangiectasia’s and small skin tags.
4. What are the advantages of using radiofrequency ablation over other available methods?
RFA is a simple, safe procedure with wider applications. It causes less lateral heat spread and tissue damage and provides better control in comparison to electric cautery. The cutting mode of radiofrequency is more effective and versatile in comparison to the carbon dioxide laser. As haemostasis occurs simultaneously, the time required for the surgery is less. There are fewer side effects and complications. RFA can be easily combined with other surgical modalities such as Cryo Therapy and laser for treatment.
5. Any precautions to be considered for this procedure?
RFA should be avoided in unstable cardiac patients and in the treatment of the lesions of the skin overlying a pacemaker. Special care should be taken while performing radiosurgery near eye. RFA should not be done in presence of oxygen as there is risk of explosion. It should be made sure that patient is in contact with the ground plate during procedure. The operator should consider wearing a surgical mask and eye protection when working on lesions containing HPV.
6. Are there any Side Effects and Complications of using this procedure?
The common side effects that occur with radiofrequency are pain, tissue edema, bleeding, infection, post inflammatory hypo/hyper or depigmentation, scarring and keloid formation. The bacterial transference of Staphylococcus aureus through electrode from one patient to another is possible; however, it is much more possible during electrodessication than during electrocoagulation.
ARYA E.N.T. SKIN CLINIC-
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Khandsa Road, Gurugram, Haryana-122001, India.
Telephone - 0124 2221223, 0124 2222223, +91 8527892223
Email - aryaentskinclinic@gmail.com