Thermic effect on metal body piercing by electrosurgery: An ex vivo study on pig skin and bovine liver

Abstract

BACKGROUND:

Piercings are placed at different body sites often invisible to medical staff. They may cause additional injuries in trauma and emergency surgery by electro-cautery.

OBJECTIVE:

To clarify whether electrosurgery will have a direct damaging effect to the skin around a pierced skin area.

METHODS:

Metallic piercings were fixed at defined distances from the neutral and active electrode on abdominal pig skin. The distance of the active electrode was reduced by 5 mm increments to 0. The respective increases in temperature were determined with a thermal camera. A macroscopic and histological analysis of the area around the piercing to detect thermal damage was carried out.

RESULTS:

Significant increases in temperature and visible changes in the tissue around the piercing only occurred when the active electrode was in direct contact with the piercing (increase of 47.3 ${}^{\circ }$ C). Electro-cautery in distance of 5 to 10 mm to the piercing showed only temperature increases of less than 5 ${}^{\circ }$ C.

CONCLUSIONS:

If metallic piercings are not directly touched by the active electrode and the distance is more than 5–10 mm, no clinically relevant effect is created on the tissue in direct proximity to the piercings by electro-cautery. In an emergency surgery situation, a piercing not fixed in direct proximity to the surgical field may likely be ignored.