Arséne d'Arsonval

The natural health and healing therapeutic effects of heat have long been recognized. More than 2,000 years ago, the Romans took advantage of heat therapies by building hot-spring bathhouses. Since then, various methods of using heat have evolved. In the early 1890s, French physiologist Arséne d'Arsonval began studying the medical application of high-frequency currents. The term diathermy was coined by German physician Carl Franz Nagelschmidt, who designed a prototype apparatus in 1906. Around 1925, United States doctor J. W. Schereschewsky began studying the physiological effects of high-frequency electrical currents on animals. It was several years, however, before the fundamentals of the therapy were understood and put into practice.

Diathermy is commonly used for muscle relaxation.

It is also a method of heating tissue electromagnetically or ultrasonically for therapeutic purposes in medicine.

* Diathermy is the use of high frequency electric current to produce heat
* Used to either cut or destroy tissue or to produce coagulation
* Mains electricity is 50 Hz and produces intense muscle and nerve activation
* Electrical frequency used by diathermy is in the range of 300 kHz to 3 MHz
* Patients body forms part of the electrical circuit
* Current has no effect on muscles

Monopolar diathermy

* Electrical plate is placed on patient and acts as indifferent electrode
* Current passes between instrument and indifferent electrode
* As surface area of instrument is an order of magnitude less than that of the plate
* Localised heating is produced at tip of instrument
* Minimal heating effect produced at indifferent electrode

Bipolar diathermy

* Two electrodes are combined in the instrument (e.g. forceps)
* Current passes between tips and not through patient

Effects of diathermy

* The effects of diathermy depends on the current intensity and wave-form used
* Coagulation
o Produced by interrupted pulses of current (50-100 per second)
o Square wave-form

* Cutting
o Produced by continuous current
o Sinus wave-form

Risk and complications

* Can interfere with pacemaker function
* Arcing can occur with metal instruments and implants
* Superficial burns if use spirit based skin preparation
* Diathermy burns under indifferent electrode if plate improperly applied
* Channeling effects if used on viscus with narrow pedicle (e.g. penis or testis)

Bibliography: Aigner N, Fialko C, Fritz A, Winks O, Zoch G. Complications in the use of diathermy. Burns 1997; 23: 256-264.: Memon M A. Surgical diathermy. Br J Hosp Med 1994; 52: 403-407

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