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Physician comments on CITECH report
| Observations from James Dolezal, MD,
Dermatologist and Medical Director of Delasco
on the Hyfrecator Plus and the Delasco 734,
Spring 1997
The CITECH report is a bench test, as stated in the conclusions on the last page "the comparison... was done on the bench, rather than in clinical use." While durability in construction and design and safety is important, it is unfortunate that CITECH did not have someone on the staff or the capability to test the unit in actual use, which of course is what is of most interest to the physician.
In the dual role of medical director of Delasco and the private practice of dermatology, I have had an opportunity not only to extensively evaluate and compare the two units, but has also been able to observe other physicians satisfaction/dissatisfaction and monitor the failure rate of the units and their components.
I have had and used both the Hyfrecator Plus and the Delasco 734 from the time of their introduction, and I still use them both regularly. The Hyfrecator Plus was introduced about 7 or 8 years ago, as the 7-796. The 7-796 had some initial design problems, and was replaced within a year by the model 7-797 which is the model available today. The 7-797 Hyfrecator Plus quickly became the leader in office electrosurgical devices.
However, physicians regularly commented about some features of the 7-797 that were undesirable. Most notably was the unreliability of the switching handle and cord. The handle and cord, as noted in the CITECH report has the capability of not only activating the electrode, but of remotely changing the power, either up or down. This feature is an advantage, for those wishing the convenience, but because of the complexity, it requires more wires. The additional wires makes the cord stiffer, and a little difficult to maneuver in a procedure, but as the cord is used, it does become a little more supple. More importantly is the tendency for the cord to fail. Failure of the cord is more likely, since there are more wires and failure of any wire renders the handpiece unusable. Depending upon which wire has shorted, the fault may even cause failure of the main unit. Because there are more wires, and the cord is stiff, the flexing induced during use seems to result in more frequent failure.
Since the warranty on accessories (the handpiece is considered an accessory) is only 90 days, replacement represents about 15% of the cost of a new unit and is not an insignificant consideration. While they still fail on a regular basis, the company has improved the cord or its construction and the failure rate has improved over that of several years ago. The Delasco 734 handle, with less wires, is more resistant to failure, and replacement handles are significantly less.
CITECH, while mentioning that the Delasco 734 can be activated simultaneously from either the handswitch or the footswitch, fails to note the practical advantage to this arrangement.
Occasionally activation by a footswitch is preferred. For example when working around a eye for a small unanesthized lesion, for example a telangiectasia, the physicianmay wish to stabilize his hand as well as the patient, and prefer to avoid introducing an additional movement such as when the finger activates the handpiece. The 7-797 takes a moderate amount
of pressure to activate, which may spoil the aim. In order to use a footswitch on the Hyfrecator Plus, it is necessary to change the handpiece, by unscrewing the connector at the bottom of the unit, and removing another connector from the front of the unit, and replacing the handpiece with a non-switched handpiece and plugging it into the front of the machine, and then screwing the foot switch connector to the receptacle at the bottom of the unit. A rather cumbersome process!
Conversely, if the optional foot switch is plugged into the Delasco 734, the handpiece is the same, and can be activated by the fingerswitch, or if simply held and the fingerswitch ignored, can be activated by the footswitch, as desired. What could be simpler?
The CITECH report does not emphasize the ease of use by being able to dial from 0.1 watt to 30 watts without having to change cords or make any other adjustment, other than instant rotation of the dial. (The dial is much faster than the electronic change required by the up and down buttons on the 7-797 handpiece or unit). In order to go over 15 watts on the 7-797, one must go to the unit, disconnect the handpiece, move a switch on the side of the machine to expose a different connection point, and then reconnect the handpiece. To go back down, the reverse is required. The practical effect of this feature, is to limit the use of the machine to 0.1 to 15 watts, as it is often easier to struggle with less than optimal power settings than to go to the trouble of changing connections.
Advantages/Disadvantages not mentioned in Citech ReportDelasco 734 (Aaron 800) | ConMed Hyfrecator Plus | Advantages
Can be activated from either the handpiece or footswitch, when the optional footswitch is used
Can use any 3/32" diameter electrode
Do not have to make any connector or different changes to power over 15 watts
Handpiece has less wires, with a reduced failure rate
All plugs including the 110V power cord can be removed, allowing a very compact unit that can be transported easily (nursing home consult).
Power changes very rapid
Disadvantages Cannot change power setting from handpiece | Advantages
Can be powered up or down from the handpiece.
Can use any 3/32" diameter electrode
Disadvantages
Must make connector changes when need to change power from under 15 watts to over 15 watts, as well as the reciprocal direction
Cumbersome to change to footswitch activation
Power plug cannot be removed, making transport somewhat more difficult
Failure rate of handpiece significant
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