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Rao SR et al, 2015: Extra corporeal shockwave lithotripsy resulting in skin burns--a report of two cases.

Rao SR, Ballesteros N, Short KL, Gathani KK, Ankem MK.
Department of Urology, University of Louisville, Kentucky, USA.
Department of Urology, Robley Rex VA Medical Center, Louisville, Kentucky, USA.

Abstract

Severe skin injury after extracorporeal shock wave lithotripsy (ESWL) is rare. We describe two patients who suffered full thickness skin burns following ESWL for renal calculi. One patient was treated conservatively and the other underwent debridement with skin grafting. We speculate that failure of the thermostatic mechanism of the lithotripter, leading to overheating of the water-filled cushion, resulted in this very rare adverse event. Proper preoperative patient counseling regarding the risk of serious burn injuries will help to avoid potential litigation.
Comment in Int Braz J Urol. 2014 Nov-Dec;40(6):857.

Int Braz J Urol. 2014 Nov-Dec;40(6):853-6. doi: 10.1590/S1677-5538.IBJU.2014.06.19. 

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Comments 1

Hans-Göran Tiselius on Thursday, 09 July 2015 10:29

The authors describe two cases of an extremely rare complication to ESWL: skin burns. The explanation provided is that the lithotripter had a defect thermostat causing too high temperatures in the cushion. Severe skin burns was the result of this failure of the lithotripter possibly in combination with extraordinary sensitive skin. It was, however, not mentioned how high the temperature might have been in the defect system. It is of note that these patients were treated with general anaesthesia. Had the patients been treated with analgesics and sedatives only, it is possible that the most severe burn could have been avoided?

The authors describe two cases of an extremely rare complication to ESWL: skin burns. The explanation provided is that the lithotripter had a defect thermostat causing too high temperatures in the cushion. Severe skin burns was the result of this failure of the lithotripter possibly in combination with extraordinary sensitive skin. It was, however, not mentioned how high the temperature might have been in the defect system. It is of note that these patients were treated with general anaesthesia. Had the patients been treated with analgesics and sedatives only, it is possible that the most severe burn could have been avoided?
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