NICE medical technologies guidance addresses specific technologies notified to NICE by sponsors. The 'case for adoption' is based on the claimed advantages of introducing the specific technology compared with current management of the condition. This case is reviewed against the evidence submitted and expert advice.
1.1 The use of the Mega Soft Patient Return Electrode during monopolar electrosurgery may offer advantages for selected patients: for example, those who would need shaving before the application of adhesive electrode pads and those with fragile or damaged skin.
1.2 It is plausible that the Mega Soft Patient Return Electrode reduces the risk of burns related to the diathermy patient return electrode where surgery is carried out in the context of good operating theatre practice. The published clinical evidence comparing the Mega Soft Patient Return Electrode against disposable single-use patient return electrodes for use during monopolar electrosurgery is limited, but there have been no reports of burns as a result of its use in the UK.
1.3 There may be system benefits for operating theatre staff using the Mega Soft Patient Return Electrode in terms of increased convenience and reduced setting up time. These benefits are more likely to be realised for inpatient operating lists than for day case surgery, and do not appear to lead to a significant reduction in resource utilisation. The economic evidence and cost modelling demonstrate near equivalent resource use to current practice.
1.4 Clinicians and managers considering the adoption of the Mega Soft Patient Return Electrode should therefore, in judging the likely benefits, take into account current practice in their operating theatres with regard to prevention of alternative site burns and the proportion of inpatient operations for which it would be used.