Nursing Instructions
Dermal Electrosurgical Shave Excision
Patient Preparation
The patient is seated or lying comfortably on an examination table. An absorbent sheet is placed beneath the site to be treated in the event any blood or fluid drains away from the treatment site (e.g., under the arm or over the collar around the neck). The electrosurgery return (antennae) plate is placed beneath the patient (it only needs to be near the patient to collect stray current).
Nonsterile Tray for the Procedure
- Place the following items on a nonsterile drape covering a Mayo stand:
- Nonsterile gloves
- 1 inch of nonsterile 4 X 4 gauze
- A 5- or 10-mL syringe filled with 2 percent lidocaine (Xylocaine), with or without epinephrine, with a 30-gauge needle attached
- 4 X 4 gauze soaked with povidone-iodine solution
- No. 15 scalpel blade
- 12 small cotton-tipped applicators
- A small disposable plastic (medicine) cup containing Monsel's solution
- A small disposable plastic (medicine) cup containing 85 percent aluminum chloride (if lesion is on the face)
- Formalin container
Electrosurgical Cart
- Electrosurgical generator
- Smoke evacuator with a special small particle (viral) filtration system
- Small dermal loop electrodes
Procedure Nursing Instructions
Hold the end of the vacuum tubing near the surgical site and activate the smoke evacuator during electrosurgery. For hemostasis, hand the cotton-tipped applicators with Monsel's solution (or aluminum chloride) to the physician (to prevent extensive reaching over the patient).
Postprocedure Nursing Instructions
- Cleanse the wound with gauze that has been dampened with saline or water. Apply antibiotic ointment and a bandage to the surgical site.
- Dispose of soiled gauze in a biohazard waste container. Dispose of the blade and needle in a sharps container.
- The electrodes are cleansed of char, washed, and soaked in glutaraldehyde (Cidex) or autoclaved before the next use.
Adapted with permission from Zuber TJ. Office procedures. Baltimore: Lippincott Williams & Wilkins, 1999.
Copyright © 2002 by the American Academy of
Family Physicians.
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