Thermic effect on metal body piercing by electro-coagulation: An ex vivo study on pig skin and bovine liver.

BACKGROUND Piercings are placed at different body sites often invisible to medical staff. They may cause additional injuries in trauma and emergency surgery by electro-cautery. OBJECTIVE To clarify whether electro-coagulation will have a direct damaging effect to the skin around a pierced skin area. METHODS Metallic piercings were fixed at defined distances from the neutral and active electrode on abdominal pig skin. The distance of the active electrode was reduced by 5 mm increments to 0. The respective increases in temperature were determined with a thermal camera. A macroscopic and histological analysis of the area around the piercing to detect thermal damage was carried out. RESULTS Significant increases in temperature and visible changes in the tissue around the piercing only occurred when the active electrode was in direct contact with the piercing (increase of 47.3∘C). Electro-cautery in distance of 5 to 10 mm to the piercing showed only temperature increases of less than 5∘C. CONCLUSIONS If metallic piercings are not directly touched by the active electrode and the distance is more than 5-10 mm, no clinically relevant effect is created on the tissue in direct proximity to the piercings by electro-cautery. In an emergency surgery situation, a piercing not fixed in direct proximity to the surgical field may likely be ignored

Image and Diagnosis Quality of X-Ray Image Transmission via Cell Phone Camera: A Project Study Evaluating Quality and Reliability

<div><h3>Introduction</h3><p>Developments in telemedicine have not produced any relevant benefits for orthopedics and trauma surgery to date. For the present project study, several parameters were examined during assessment of x-ray images, which had been photographed and transmitted via cell phone.</p> <h3>Materials and Methods</h3><p>A total of 100 x-ray images of various body regions were photographed with a Nokia cell phone and transmitted via email or MMS. Next, the transmitted photographs were reviewed on a laptop computer by five medical specialists and assessed regarding quality and diagnosis.</p> <h3>Results</h3><p>Due to their poor quality, the transmitted MMS images could not be evaluated and this path of transmission was therefore excluded. Mean size of transmitted x-ray email images was 394 kB (range: 265–590 kB, SD ±59), average transmission time was 3.29 min ±8 (CI 95%: 1.7–4.9). Applying a score from 1–10 (very poor - excellent), mean image quality was 5.8. In 83.2±4% (mean value ± SD) of cases (median 82; 80–89%), there was agreement between final diagnosis and assessment by the five medical experts who had received the images. However, there was a markedly low concurrence ratio in the thoracic area and in pediatric injuries.</p> <h3>Discussion</h3><p>While the rate of accurate diagnosis and indication for surgery was high with a concurrence ratio of 83%, considerable differences existed between the assessed regions, with lowest values for thoracic images. Teleradiology is a cost-effective, rapid method which can be applied wherever wireless cell phone reception is available. In our opinion, this method is in principle suitable for clinical use, enabling the physician on duty to agree on appropriate measures with colleagues located elsewhere via x-ray image transmission on a cell phone.</p> </div

Teleradiology requirements.

<p>Teleradiology requirements.</p

Tally of accurate confirmations of final diagnoses after assessment of transmitted images by 5 specialists.

<p>No significant differences were found regarding the specifications “no pathological findings“ and “with diagnoses”.</p