Surgical Electrocautery

Case Synopsis

A 59-year-old man is having an open resection of the right colon for cancer. The surgeon is having a difficult time getting exposure, due to adhesions from a previous surgery. On several occasions, he complains that the electrosurgical unit (ESU) is not working properly and wants the energy increased. The circulating nurse complies with his requests. Eventually a new ESU is obtained, but this does not solve the problem. The operation is completed after 3 hours, and the patient is transferred to the postanesthesia care unit (PACU). When the PACU nurse replaces the electrocardiogram (ECG) electrodes, she notes second-degree burns under two of the pads.