Electrosurgery has been in practice since the early 20th century as a means of controlling bleeding. Surgeons use radiofrequency currents to cut and coagulate tissue for the purpose of hemostasis or electrocautery of tissue.
With the use of basic safety measures, electrosurgery is a safe and effective incisional minimally invasive surgical instrument.
Accidental electrical burns or shocks during electrosurgery are one of the occupational hazards in the operating room. Those who have experienced the event usually blame the hole in the surgical glove, believing that the clinician simply needs to replace the glove and continue the procedure.
The impedance or resistance characteristics of surgical gloves may be reduced by wear and exposure to blood and fluids, or sweat inside the glove. A "bulge" is usually seen at the finger end, indicating that the glove has lost some of its protective barrier properties, known as "hydration". Surgical gloves with slow "hydration" provide additional protection against electric shock during electrosurgery. Regular glove changes and double glove wear during surgery can also prevent these problems from occurring.
In electrosurgery, the surgeon's sweaty, conductive skin and the metal hemostats applied to the blood vessels are considered two conductors separated by an insulator (glove barrier). The thinner the glove film, the higher the chance of electric shock. Therefore, choosing a better barrier (e.g., extra-thick gloves) may be more effective protection for the surgeon when performing electrosurgery.
This occurs when the glove barrier cannot withstand the high energy forces from the electrosurgical generator. If the voltage is high enough, it may create holes in the glove and cause burns.
In general, because of the properties of rubber, surgical gloves can be considered non-conductors; they can be considered, to some extent, as insulating media when performing electrosurgery. However, gloves are not made for this purpose and therefore should not be relied upon exclusively to provide insulating "failsafe" protection.