title: Use of an ultrasonic scalpel as an alternative to electrocautery in patients with pacemakers.
abstract: We report the safe and effective use of an ultrasonically activated scalpel as an alternative to unipolar electrocautery during surgical procedures in 4 patients with pacemakers. This scalpel provided adequate hemostasis without the adverse consequences of electromagnetic interference. As the scalpel was able to easily cut through the silicone connector sleeve of one generator, it is not recommended for routine generator replacement because it may damage existing pacing leads. However, its use during nonpacemaker operations in patients with pacemakers should be considered.
authors.affiliation: Department of Cardiology, Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115-5737, USA.
authors.forename: M R
authors.initials: MR
authors.lastname: Epstein
authors.forename: J E
authors.initials: JE
authors.lastname: Mayer
authors.forename: B W
authors.initials: BW
authors.lastname: Duncan
mesh_terms: D000328:Adult; D016470:Bacteremia / Q000382:microbiology; D001424:Bacterial Infections / Q000601:surgery; D017577:Cutaneous Fistula / Q000601:surgery; D004564:Electrocoagulation / Q000295:instrumentation; D055590:Electromagnetic Phenomena; D005260:Female; D006406:Hematoma / Q000601:surgery; D006488:Hemostasis, Surgical / Q000295:instrumentation; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial / Q000009:adverse effects; D012449:Safety; D012828:Silicones; D013203:Staphylococcal Infections; D013207:Staphylococcal Skin Infections / Q000601:surgery; D013514:Surgical Procedures, Operative; D014464:Ultrasonic Therapy / Q000295:instrumentation*
chemical_list: D012828:Silicones