Return-Electrode-Site Burns: When the Risks Are Greatest

The increasing use of electrosurgical devices and techniques that apply high currents to the patient for long periods of time, such as radio-frequency (RF) ablation, has led to an increased risk of skin burns at the return electrode site. Heating factor (HF) is a term defined in the electrosurgery industry as the (current)2 × (time) in units of amperes2 seconds (A2s) to describe the likely thermal "stress" that a return electrode will receive. For decades, standard conductive return electrodes have been expected to handle 30 A2s, which has been considered to provide a significant safety margin.