What is radiofrequency ablation (RFA)?

 

Radiofreqeuency 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.

 

How does RFA work?    

 

Modern high - frequency radiosurgical devices transfer electrical energy to human tissue via a treatment electrode that remains cool. The electrical resistance of human tissue helps in converting this electrical energy into molecular energy; this causes the denaturation of intracellular and extracellular pro teins, thereby resulting in coagulation or desiccation effects.

 

What is electrocautery?

 

Electrocautery is the process of destruction of tissue by passage of electric current.

 

What can you treat with Radiofrequency ablation and Electrocautery?

 

Both these p rocedures are used in a variety of indications in Dermatology; namely, treatment of Warts, Seborrhoeic Keratosis, Dermatosis papulosa Nigra, Freckles, Skin Tags, Small Basal cell Carcinomas, Lymphangiomas, Pyogenic Granulomas, Nail Surgery. Newer devices w ith RFA can be used in resurfacing of skin, treatment of Rhinophymas, leg veins.

 

What are the advantages of using Radio frequency ablation?

 

• 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 hemostasis (stopping of bleeding) occurs simultaneously, the time required for the surgery as well as the time required for healing is less.

• There are fewer side effects and complications.

• RFA can be easily combined with other surgical modalities such as cryotherapy and laser for treatment.

• Topical creams containing EMLA are often enough to anaesthetize the skin tissue prior to RFA or electro cauterization,thus resulting in pain free treatment.

 

Which subsets of patients are unfit for Radio frequency ablation?

 

• 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.

 

What are the possible side effects of the procedure?

 

The procedures are extremely safe in trained hands. The potential side effects are Pain, tissue edema , bleeding, infection, post inflammatory hypo/hyper or depigmentation, scarring and keloid formation in susceptible patients.

 

What should be the Post Radiofrequency ablation and Electrocautery care?

 

• Skin tissue completely heals in 7 - 14 days, thus the time required for the healing varies from patient to patient

• Apply the antibiotic creams as advised for 5 - 7 days post RFA or electrocautery

• Dark skin is susceptible to post Procedure hyper/ hypo pigmentation. This can not be predicted at the time of the proce dure. However it can be managed with specific lightening creams afterwards.

• Apply sunscreen lotion regularly post these procedures on sun exposed areas.

 

 

TEAM SIG – Dermatosurger