High Frequency Heat Therapy *physical stimulus employed of physiotherapy

is in the form of heat, either by simple heat radiation or by the application of high frequency energy obtained from special generators.

*The use of high frequency energy in thermotherapy has the advantage of considerable penetration as compared with simple heat application.

High Frequency Heat Therapy

*Thus with high frequency energy ,dipper lying e.g., muscles, bones, internal organs,ect. Can provide heat. *High frequency heat therapy is based on the based on the fact that the dipole molecules of the body are normally placed randomly under the influence an electrical field

*they rotate according to the polarity of their charge *in the direction of the field they rotate according to the polarity of their charge in the direction of the field lines

*The positively charge end of the dipole then orients itself to the minus pole and the negatively end to the plus pole.

*Since the polarity of the electric field alternates, a micro-heating effect results from the continuous realignment of the molecules. High frequency energy for heating is obtained by various ways.

*It may be from the short-wave therapy unit making use of either the condenser field or the inductor field method.. *Microwaves and ultrasound waves are also used for heating purposes in special cases.

WHAT IS ELECTROSURGICAL DIATHERMY ? *Electrosurgery defined as the use of radio frequency electric curent to sever tissue or achieve hemostasis. *A high frequency is used because a low frequency (below 100,000 Hz) will stimulate nerves or in other words can electrocute the patient .

* Medical diathermy is similar to Electrosurgery in that a radio frequency current is passed through the patient body. Entry and exit electrodes are chosen so that tissue heating is never high enough to cause necrosis.
*Typically electrosurgical generators can operate at frequencies up to 4 MHz, at these frequencies reactive phenomenon (capacitance and inductance) become quite prominent. Therefore some famous models like VALLEY LAB SSE2K operate at 500 kHz.

SURGICAL EFFECTS OF DIATHERMY:There are three surgical effects which can be achieved by Electrosurgery :
*ELECTROSURGICAL DESSICATION

(low power coagulation with out sparking).

* ELECTROSURGICAL CUTTING (electric sparking to tissues with cutting effect). * ELECTROSURGICAL FULGURATION (electric sparking to tissues without cutting effect).

CONTROL PANEL

AUDIO TONE GENERATOR

ISOLATIO N SWITCH BOARD

LOGIC BOARD

POWER OUTPUT BOARD

FOOT SWITCH

POWER SUPPLY

BLOCK DIAGRAM OF SURGICAL DIATHERMY

ELECTROSURGICAL DESICCATION:*In desiccation electric current is passed through the electrical resistance of tissue and heat arises in the tissue. *when the tissue becomes hot water is driven out of the tissue Visually during desiccation tissue becomes brown then it steams as the water is driven out. *SSE 2K can perform desiccation with either BLEND , CUT or COAG.

ELECTROSURGICAL CUTTING:*In electrosurgical cutting objective is to heat the tissue so rapidly that cell explodes into steam, leaving a cavity in the cell matrix .

*The heat is dissipated in the steam and , therefore it does not conduct through the tissue to dry out adjacent cells.
*When the electrode is moved and fresh tissue is contacted , new cells are exploded and the incision is made . *When the radio frequency current jumps across the air gap to tissue .

*The bright light in the air gap is technically called spark. *An ARC is a similar phenomenon which requires longer intervals to become established . Electrosurgical cutting involves sparking to tissue . *A hot cattery wire ( a heated wire with no electric current ) can also cut the tissue by the mechanism explained above)

*The essential characteristic of CUT is that they are continuos sine waves . That is if the voltage is plotted over time a pure CUT wave form is a continuos sine wave at 500 kHz

ELECTROSURGICAL FULGURATION:*COAG wave form generally consists of short bursts of radio frequency sine wave. *The frequency is 450 kHz and the bursts occur at 20,000 times/second .
*the average power delivered in a COAG wave is less because it is turned off most of the time .

*A good COAG wave form without significant cutting effect because the heat is more widely spread by the long sparks and because the heating is intermittent.

*The temperature of water in the cells does not go high enough to flash into steam, in this way cells are dehydrated slowly and are not torn apart to form an incision .

*Some times desiccation and fulguration are thought to be same , Fulguration can be contrasted with desiccation in several ways ..first, sparking to tissue always produces necrosis, whereas desiccation may not produce necrosis.

Typical current = 0.5 Amp. Electrode in good contact with the tissue. Deep coagulation. Spreads rapidly. Relatively soft,light brown eschar.

Typical current 0.1 Amp. Electrode free from tissue. Long sparks result in superficial coagulation Deeper necrosis as fulguration continues. Eschar is hard and black.

Typical current 0.1 Amp. Electrode is separated from

tissue by a thin layer of steam. Small intense sparks flash cells into steam. Hemostasis can be minimal.

PATIENT RETURN ELECTRODE:*When using monopolar electrodes, a patient return is always required because it provides a mean for the current to leave the patients body safely and return to the generator.

*The patient return electrode must be considerably larger than active electrode so that the current density is kept low and no significant heating occurs. * This return electrode is referred to as patient return electrode and not ground plate because there is a confusion which might make people to assume that it is convenient goring for ECGs or other purposes.

TECHNICAL SPECIFICATION:OUTPUT WAVEFORM ( Typical ):-

CUT: 500 KHz SINUSOID WITH 65% 120 Hz MODULATION.

COAG: PULSE MODULATED 450KHz DAMPED SINUSOID. BURST DURATION 7.0u SEC. BURST REPITITION 20KHz.

BLEND: 500KHz SINUSOID WITH INCREASED AMPLITUDE .

FOOT SWITCH

Short -Wave Diathermy

*The term of *diathermy* means through heating or producing deep heating directly in the tissues of the body. *Externally applied sources of the heat like hot towels, infrared lamps and electric heating pads ,often produce discomfort and skin burns long before adequate heat has penetrate to the deeper tissue.

*But with the diathermy technique, the subjects body becomes a part of the electrical circuit and the heat is produced within the body and not transferred through the skin. , Another advantage of diathermy is that treatment can be controlled precisely.

*Careful placement of the electrodes permits location of the heat to the region to

*that has to be treated the amount of heat can be closely adjusted by means of circuit parameters. *the heating of tissues is carried out by high frequency alternating current which generally has a frequency of 27.12KHz and the wavelength of 11m. *Currents of such high frequencies do not stimulate motor or sensory nerves, nor do they produce any muscle contraction. Thus

*when a such a current is passed through the body, no discomfort is caused to the subject. *The current being it is possible to pass through the tissue currents of a much greater intensity to produce direct heating in the tissues similar to any other electrical conductor.

*The method consist in applying the out put of a radio (RF) oscillator to a pair electrodes which are positioned on the body over the region to be treated. *The RF energy heats the tissues and promotes heating of injured tissues and inflammations.

The short wave diathermy machine consists of two main circuits * Oscillating circuit: which produced high frequency current.
* Patient circuit: which is connected to the oscillating circuit and through which the electrical energy is transferred to the patient.

Application technique of short-wave therapy:

*The pattern of tissue heating is generally affected by the method of short-wave diathermy delivery. *The two most common forms of application include the capacitor plate method and the inductive method.

*In the capacitor plate method, the out put of the short-wave diathermy machine is connected to metal electrodes which are positioned on the body over the region to be treated. * This electrodes called *PADS* in the terminology of the diathermy.

Application technique of short-wave therapy: *These pads or electrodes do not directly connect with skin. Usually layers of towels are interposed between the metal and the surface of the body. *The pads are placed to that portion of the body to be treated is sandwiched between them. This arrangement is called the

. *Condenser Method* wherein the metal pads act as two plates while the body tissues between the pads as*dielectric* of the capacitor

*When the radio frequency out put is applied to the pads, the dielectric losses of the capacitor manifest themselves as heat in the intervening tissues.
*The dielectric losses may be due to vibration of ions and rotation of manifest in the tissue fluids (electrolytes) and molecular distortion in tissues which are virtually insulators like fat

*Alternatively, the output of the diathermy machine may be connected to a flexible cable instead of pads. This cable is coiled around the arm or knee or any other portion of the of the body where plate electrodes are inconvenient to use

*When RF current is passed through such a cable ,an electro static field is set up between its ends and a magnetic field around its centre. *Deep heating in the tissue results from electrostatic action whereas the heating of the superficial tissues is obtained by eddy currents set by a magnetic effect. This technique is inductothermy.

*Although most of the short-wave diathermy machines have an out put power Control, yet there is no indication of the amount of converted and absorbed heat within the body tissues. *Therefore ,the intensity of treatment is dependent on the sensation of warmth felt by the patient.

Microwave diathermy
*This type consist of in irradiating the tissues of the patients body with very short wireless waves having frequency in the microwave region.
*Microwaves are a form of electrodes magnetic radiation with a frequency rang of 300-30,000MHz and wave length varying from 10mm to 1m.

*The most commonly used microwave frequency for therapeutic heating is 2450Mhz corresponding to a wavelength of 12.25 cm. *microwave diathermy provides one of most valuable sources of therapeutic heat available to the physician

Microwave diathermy
*Effect of microwave diathermy are similar to short-wave yet in other better result are obtained by using microwave.
*The technique application of microwave diathermy is very simple. Not like shortwave

* the pads are used to bring in the patient as a part of the circuit, the microwave are transmitted from an emitter, and are directed towards the portion of the body to be treat.
*Thus no tuning is necessary for individual treatments These waves pass through the intervening air space and are absorbed by the surface of the body producing the heating effect.

*such currents produced by special type of device called*magnetron* is used for the production of high frequency currents of high power.

*The magnetron consist cathode surrounded by structure that contains into the cathode-anode slots.

of cylindrical an anode cavities opening space by mean

*the out put energy is derived from the resonator system by means of a coupling loop which is forced into one of the cavities. *The energy picked up on the coupling loop is carried out of the magnetron on the central conductor of a co-axial out put tube through a glass seal to a director which consist of radiating element of antenna and a reflector which directs the energy for application to the patient

*The electrical current is transformed into electromagnetic radiation on passing through the antenna. *The reflector then focuses this electromagnetic energy and beams into the where subsequence absorbed, reflected or refracted, according to the electrical properties of the tissue

*Tissues of lower water content are penetrated to greater depth by this little is absorbed, whereas tissues of high water content absorbed electromagnetic energy but allow little penetration. *the out put power magnetron depends upon anode voltage, magnetic field and the magnitude and phase of the load impedance to which the magnetron out put power is delivered.

*Therefore the cable used to carry the energy from the magnetron to the director is always of a define length for a particular frequency. *A part of the energy fed to the magnetron is also converted into heat in the anode on account of the collision of the electron with the anode so that the out put energy is considerably less than the input energy.

*The efficiency of a magnetron is usually 40-60% the heat produced at the anode must be removed which usually done by using water or air as means of cooling.

Repair Tips
Problem
*No Output in any mode. *Output Coagulation OK No Cut. *Cut OK no Coagulation. *Hand control OK Foot switch not working. *Machine at no response. *Low output in Cutting OR Coagulation Mode.

Causes of these Problems

No Output in any Mode:
Pencil Error. Power Driver may be faulty. Fault in RF board .

Output Coagulation OK No Cut:

Fault in Pencil/foot paddle. Iso-block board must be checked. Multi-vibrator board may have some error. Output relay in the main board may not working properly.

Causes of these problems

Cut OK No Coagulation: Fault in Pencil/foot paddle. Iso-block board must be checked. Multi-vibrator board may have some error. Output relay in the main board may not working properly. Hand control OK Foot switch not working. Foot switch connector damage. In continuity in the wires of paddle.

Causes of these repairs Machine at No response.

Error in Power switch. Problem in power board. Problem Cooler assembly.

Low Output in Cutting or Coagulation mode.

Fuse may be open. May be fault of Power Transistor.

Rust on Patient Plate.