This topic has been introduced in the new edition of Bailey & Love - 26th. This topic covers the types, uses & special uses as well as complications of Diathermy.

2. Introduction
Forms of diathermy
Surgical uses & Types of diathermy
Complications

3.  Diathermy, form of physical therapy in which
deep heating of tissues is accomplished by
the use of high-frequency electrical current.
 The term diathermy is derived from the Greek
words “Therma”, meaning heat, and “Dia”,
meaning through.
 Diathermy literally means “Heating through”.
 Carl France Nagelschmidt, a German
physician, in 1909 coined the term diathermy.

4.  Depending on the amount of heat
generated, diathermy can be used to merely
warm or to destroy tissue.
 In the first instance, it is particularly beneficial
in relieving muscle soreness and sprain.
 In the second, as an adjunct to surgery,
diathermy is used to coagulate, prevent
excessive bleeding, and seal off traumatized
tissues.
 It is particularly effective in eye surgery,
neurosurgery & dermatology.

5. 3 forms of diathermy - wide use in hospitals :
Shortwave
Ultrasound
Microwave

6.  In shortwave diathermy, the part to be
treated is placed between two
condenser plates, and the highest
temperature is concentrated in the
subcutaneous tissues.
 It is usually prescribed as treatment for
deep muscles and joints and is
sometimes used to localize deep
inflammatory disease.

7.  It uses high-frequency acoustic vibrations;
their heating effect ↑ circulation and
metabolism and speeds up the rate of ion
diffusion across cellular membranes.
 During treatment the apparatus is moved
slowly across the surface of the area to be
affected.
 Ultrasound is used to heat selected muscles
that are too deep to be significantly
affected by surface heating.

8.  Microwave diathermy uses radiation of
very high frequency & short wavelength
similar to radar waves.
 All physiologic responses are due to its
heating effect.
 Microwave diathermy is used in the
management of superficial tumours with
conventional RT & CT.

9.  Surgical diathermy is usually better known
as "electrosurgery". (It is also referred to
occasionally as "electrocautery“)
 Electrosurgery and surgical diathermy
involve the use of high frequency A.C.
electrical current in surgery.

10. Diathermy can be used for 3 purposes :
Coagulation – Sealing of blood vessels.
Fulguration – the destructive coagulation
of tissues with charring.
Cutting – used to divide tissues during
bloodless surgery.

11.  MONOPOLAR
 BIPOLAR

12.  Where electrical current passes from
one electrode near the tissue to be
treated to other fixed electrode
(indifferent electrode) elsewhere in the
body.
 Usually this type of electrode is placed
in contact with buttocks or around the
leg.

13.  Active electrode in
surgical site.
 Patient return
electrode – electrical
plate – attached
elsewhere.
 Current flows through
patient.
 Localised heating at
tip of instrument.
 Minimal heating on
plate as more surface
area.

15.  Bipolar, where both electrodes are
mounted on same pen-like device and
electrical current passes only through the
tissue being treated.
 Advantage of bipolar electrosurgery is
that it prevents the flow of current
through other tissues of the body and
focuses only on the tissue in contact.
 This is useful in microsurgery and in
patients with cardiac pacemaker.

18.  Explosion
 Burns
 Lap.surgery

19.  Sparks from diathermy can ignite any
volatile or gases or fluid within the
theatre.
 Alcohol based skin preparation can
catch fire if they are allowed to pool or
around the patient.

20.  Faulty application of the
indifferent electrode
with inadequate
contact area.
 Patient being earthed
by touching any metal
object.
 Faulty insulation of
diathermy leads.
 Inadvertent activity
such as accidental
activation of foot
pedal.

21.  Diathermy of wrong structure becoz of
lack of clarity of vision.
 Faulty insulation of any lap instrument.
 Intraperitoneal contact of diathermy
with another metal instrument.
 Inadvertent activity while tip is out of
vision of the camera.
 Retained heat in the tip – touching the
bowel.

22.  Short circuit instances leading to
electrocution
 Interfere with pacemaker function
 Channeling effects if used on viscus with
narrow pedicle (e.g. penis or testis)