Preoperative Practice; Cutting Practice; Coagulation Practice; General Principles Of Electrosurgery Technique - Coltene PerFect TCS II Benutzerhandbuch

Owner's Guide
control to the center "0" position and unscrew the electrode sheath
from the handpiece cord assembly for sterilization.
Please Note: In compliance with IEC 60601-2-2, requirements for
the safety of high frequency surgical equipment, this unit generates
an audible tone when operated.

Preoperative practice

This guide is not intended to be a substitute for formal instruction.
The new user of electrosurgery is strongly urged to undertake
adequate study before performing clinical operative procedures.
After receiving instruction, practicing on raw, lean beef can help
the practitioner acquire the necessary dexterity to achieve superior
clinical results. Select a piece of fresh, lean beef (round steak or shin
beef) and allow to reach room temperature.

Cutting practice

1.
Place the meat on the dispersive electrode.
2.
Thread the Straight Knife electrode sheath onto the handpiece
swivel connector.
3.
With the power switch "On," rotate the Intensity Control to
position "1" in the Cut mode (to the right).
4.
Depress the footswitch to activate the electrode.
5.
Using a smooth, rapid, brush-like motion, make several incisions
of varying length and depth (Figure 4). You may find it helpful
to use a finger rest to achieve precise control. Observe that the
electrode either fails to cut or does so only with considerable
dragging. Note also that cutting, if it occurs, causes tissue
shreds to adhere to the electrode tip.
6.
Repeat the procedure above at successively higher intensity
settings. If the electrode encounters appreciable resistance, the
setting is too low. Increase the setting until there is no resistance
to cutting and there is no sparking and no discoloration along
the incision. This point is the lowest effective intensity setting
for a practice procedure. Allow 10–15 seconds for the tissue to
cool before cutting again in the same area.
7.
Increase the intensity setting one position above that which
provided optimum results. Observe sparking and discoloration
in the form of charring and tissue blanching along the
cutting track.
Continue to practice a variety of incisions using different electrodes
and with the intensity setting at different levels. Observe the cutting
results and the action of the electrode tip when settings are too low,
too high, or correct. For best results, use the lowest effective output
intensity; this is the proper setting for most procedures.

Coagulation practice

With a little practice, coagulation is easily achieved with the
PerFect TCS II. Use the same specimen of lean beef on the dispersive
electrode. Simulation of effective coagulation is achieved when the
treated area shows a blanched spot of approximately 2 mm or less
in diameter.
1.
Insert the Coag Ball electrode and rotate the Output Control to
position "1" on the Coag scale (to the left).
2.
Activate the electrode and, with a dabbing motion, place the
ball tip in light contact with the specimen, maintaining contact
for approximately 1 second. Allow 10–15 seconds for the
tissue to cool and repeat the procedure until a blanched spot
indicates that coagulation is achieved.
3.
Repeat this technique
intensity settings until blanching occurs after one or two
applications of the electrode: this is the proper setting for most
coagulation procedures.
4.
Also practice coagulating with the Straight Knife electrode,
which is particularly useful in hard to reach areas. However,
since the Straight Knife electrode focuses energy in a smaller
area, the intensity setting should be lower than that used with
the Coag Ball electrode.

General principles of electrosurgery technique

The following guidelines will help you benefit from the advantages
of electrosurgery. For additional important information, please refer
to the Special Notes and Precautions section.

Placement of equipment

It's important to place the PerFect TCS II unit so that the controls,
handpiece, electrodes, and accessories are readily accessible for use
with a minimum of motion and wasted time. The unit should be
plugged in at all times and the console should be within arm's reach
of the operator. All of the functions, controls and settings should be
controlled by the dentist.

The dispersive electrode

The dispersive electrode ensures that the energy flow from the small,
active electrode is predictable and uniform. It must be used during
all electrosurgical procedures. The entire area of the dispersive
electrode should be placed in firm, nonconductive contact with the
patient, preferably against the patient's upper back, contacting the
maximum possible area.
CAUTION:
Do not place the dispersive electrode in contact
with bare skin. Hand-held or hand-worn dispersive electrodes
should not be used.
The patient, operator or assistant should not come into contact
with metal parts, such as metal arm rests of chairs. Use only
non-conducting (plastic) instruments (mirror, retractor, saliva
evacuation tube, etc.) when performing procedures.

The cutting stroke

Your cutting stroke should be smooth, rapid and brush-like. Before
each cut, you may find it helpful to try several practice strokes with
an inactive electrode, much as a golfer takes practice strokes before
putting. This will help you assume a comfortable grasp on the
handpiece and will enable you to plan the position and length of
the actual cutting stroke. Remember to use the lowest effective
output setting for best results. When cutting, use several short
strokes rather than a single long stroke. Rather than commit to a
single irreversible cut (as you must do with a scalpel), you may find
it preferable to shave tissue in very fine layers to achieve a more
precise, aesthetically pleasing result. Cutting precision can also be
enhanced by using a finger or hand rest to steady your stroke.
CAUTION:
If your cutting stroke is too slow, or if you leave
the electrode too long in one area, a build-up of lateral heat
may cause necrosis and sloughing of tissue.
at successively higher output
5