- 期刊
Electrosurgical Unit Causing Alternate Burn Injury While Performing Extracorporeal Membrane Oxygenation Implantation
置入體外膜氧合器時單極電燒造成異位性燒傷之案例
摘要
背景：手術電燒器很常被應用在手術中。通常，手術電燒器是非常安全。但是仍然有一些手術風險如手術中火災、回流電燒貼片燒傷、或異位性燒傷。目的及目標：經由案例分析，分享如何治療此類燒傷的經驗。材料及方法：這是一個二十一歲女性，十天前接受拔牙手術。因為發燒、嗜睡、噁心、及呼吸困難而被送到我們的急診室。當時有心因性休克，診斷為急性心肌炎。當場心臟血管外科醫師馬上執行床邊體外氧合器的置入。手術完成後，撤離無菌布單時，發現在病人的會陰及兩側大腿有體表面積百分之五、二度至三度的燒燙傷（一些優碘消毒水溶液殘留在左側會陰部周圍）。之後，我們對右內側大腿執行分層皮膚移植。對於左側大腿，清除壞死組織後，行初級傷口縫合。結果：在九個月的追蹤後，燒傷傷口癒合穩定。結論：手術電燒器的風險包含手術中火災、回流電燒貼片燒傷、或異位性燒傷。回流電燒貼片燒傷通常發生在電燒貼片脫落或貼在不適當的部位。異位性燒傷和雜散電流的產生有關。在這份報告中，我們提供對於這類燒傷的解決方法。
關鍵字
無資料並列摘要
Background:The electrosurgical unit (ESU) is a reputable tool in the operating room. Normally, ESU is safe, but there are still some risks involved such as the likelihood of surgical fire, return electrode burns, or alternate site burns.Aim and Objectives:To share our experience of how to treat these kinds of burns through explication of a case study.Materials and Methods:A 21-year-old female patient had had a dental procedure 10 days previously, then came to our emergency department (ED) owing to fever, dizziness, nausea and dyspnea. Cardiogenic shock was noted, and a diagnosis of acute myocarditis was opined. On the spot, cardiovascular surgeons performed bedside extracorporeal membrane oxygenation (ECMO). After the surgical drapes were removed, 2nd to 3rd degree burns were discovered around the perineum and bilateral medial thighs (Iodophor had been applied around the left perineum area). Next, we performed a split-thickness skin graft (STSG) for the right medial thigh. For the left thigh, the necrotic tissue was excised and primary closure of the site was performed.Results:After a nine-month follow-up, the burns were stable.Conclusion:The risk of ESU includes surgical fire, return electrode burns, and alternate site burns. Return electrode burns usually occur if the electrode becomes detached or has been improperly placed. Alternate site burns are related to stray currents exiting. In this documentation, we provide some solutions to prevent this kind of burns.