Comparative Healing of Human Cutaneous Surgical Incisions Created by the PEAK PlasmaBlade, Conventional Electrosurgery, and a Standard Scalpel

Ruidiaz, Manuel E.; Messmer, Davorka; Atmodjo, Dominique Y.; Vose, Joshua G.; Huang, Eric J.; Kummel, Andrew C.; Rosenberg, Howard L.; Gurtner, Geoffrey C.

doi:10.1097/prs.0b013e31821741ed

Cited by 78 publications

(88 citation statements)

References 20 publications

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“…The LTD used in this study has previously been shown to significantly decrease the depth of thermal injury during dissection of skin and fascia in clinical and preclinical studies, minimizing collateral tissue damage, and providing a healing profile equivalent to scalpel. [14][15][16][17][18][19] This LTD has also been shown to reduce scarring and wound necrosis 20 as well as to improve surgery time, hospital stay, and cost in select applications. 21 This LTD has not yet been assessed in ACDF; thus, this pilot study was designed to evaluate and compare its properties with ES in a cadaveric model.…”

Section: Discussionmentioning

confidence: 99%

Preclinical Comparison of Thermal Tissue Effects from Traditional Electrosurgery and a Low-Temperature Electrosurgical Device during Anterior Cervical Discectomy and Fusion

et al. 2018

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Background: Exposure of the anterior cervical spine requires dissection in proximity to critical neurovascular structures. Monopolar electrosurgical (ES) devices generate heat in contacted tissues, resulting in thermal damage and temperature change. This study examined depth of thermal injury and temperature change associated with use of a lowtemperature electrosurgical device (LTD) compared to traditional electrosurgery during a cadaveric anterior cervical discectomy and fusion (ACDF) dissection.Methods: ACDF was performed, using ES or LTD, on cervical spines (C3-4 and C4-5) from 2 fresh human cadavers with intact neck soft tissues and no history of surgery. Cadavers were maintained at 22-238C, and fiber-optic temperature sensors (Neoptix, Qu´ebec City, Qu´ebec, Canada) were placed near relevant structures to measure changes during dissection. Depth of thermal injury was assessed by hematoxylin and eosin and Masson's trichrome histology of fixed tissue specimens.Results: Use of the LTD resulted in a statistically significant reduction in temperature change at platysma (3.0 6 1.04 vs. 11.41 6 3.108C, P ¼ .003), carotid sheath (7.32 6 1.13 vs. 15.57 6 2.568C, P ¼ .007), and longus colli (6.11 6 1.32 vs. 12.9 6 3.628C, P ¼ .016) compared to ES. Temperature change at the trachea was similar between groups (6.06 6 1.99 vs. 4.96 6 1.898C, P ¼ .528). Histology showed that LTD produced less mean and maximal depth of thermal injury compared to ES (mean: 0.5 vs. 1.2 mm; max: 0.9 vs. 1.8 mm; P , .05).Conclusions: The results of this pilot study demonstrate that anterior cervical spine exposure using an LTD reduces tissue temperature change and depth of thermal injury compared to ES.Clinical Relevance: Although exploratory, these results suggest that use of an LTD during ACDF may reduce the extent of thermal tissue injury during dissection. Future studies in live animal models are warranted to determine if thermal injury is a potential cause of common exposure-related complications, such as dysphagia and dysphonia.

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Section: Discussionmentioning

confidence: 99%

Preclinical Comparison of Thermal Tissue Effects from Traditional Electrosurgery and a Low-Temperature Electrosurgical Device during Anterior Cervical Discectomy and Fusion

et al. 2018

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“…This feature of the device is presented as a factor which reduces tissue ischemia. 13 Ischemia-modified albumin (IMA) has emerged as a sensitive biomarker in the evaluation of tissue ischemia, and was used in many ischemic conditions such as myocardial ischemia, skeletal muscle ischemia, pulmonary embolism, and stroke. [13][14][15][16] To the best of our knowledge, there are no studies showing whether this increases after axillary dissections during mastectomy.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Electrocautery and Plasmablade on Ischemia and Seroma Formation after Modified Radical Mastectomy for Locally Advanced Breast Cancer

Alptekın

Yılmaz

Öztürk

et al. 2017

Surgical Techniques Development

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The aim of this study was to compare postoperative drainage volumes and IMA levels in patients who underwent modified radical mastectomy (MRM) with using PlasmaBlade (PB) or electrocautery (EC). A total of 36 patients who underwent MRM with PB or EC in our clinic between August 2012 to February 2013 were enrolled. Number of removed and positive lymph nodes, duration of drainage and total drainage volume was recorded. Seroma formation after drain removal and number of aspirations were also recorded. Serum ischemia modified albümine (IMA) levels were analysed before surgery, 1 hour and 24 hour after surgery. In total, 36 patients were treated with MRM in the study period. Of the 36 patients, 16 underwent MRM with PB, and 20 underwent MRM with EC. The patients demographics were similar in both groups. The mean drainage volume and seroma formation were significantly higher in the PB group when compared with EC group (P<0.05). Number of aspirations due to the seroma were also high in PB group. The total aspiration volume of seroma was not different in both groups. IMA levels 24 hours after surgery in the PB group was significantly higher than EC group. There was no statistical significance between the groups for IMA levels at 1 st hour. PB is a monopolar energy device and is associated with increased levels of ischemia. This situation resulted with an increased volume of total axillary drainage and elevated risk of seroma formation.

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“…Plasma creates an electrically conductive cloud when radiofrequency energy contacts tissue [9]. An advantage of PlasmaKinetic is cutting the tissues at a much lower average temperature (as low as 50°) than conventional electrocautery [10]. As a result of this, thermal damage of the surrounding tissue is less than 1 mm.…”

Section: Discussionmentioning

confidence: 99%

PlasmaKinetic™ versus Cold Knife Internal Urethrotomy in Terms of Recurrence Rates: A Prospective Randomized Study

Çeçen

Karadağ²,

Demir³

et al. 2014

Urol Int

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Objective: To evaluate the efficacy and outcomes of PlasmaKinetic™ urethrotomy against cold knife direct vision internal urethrotomy in terms of recurrence rates. Patients and Methods: A total of 136 male patients with urethral strictures were enrolled into the study. The patients were allocated to cold knife or PlasmaKinetic urethrotomy groups sequentially by using computer-generated numbers. Group A (PlasmaKinetic) and group B (cold knife) included 70 and 66 patients, respectively. All patients were reevaluated at the 3rd, 9th and 18th month postoperatively with uroflowmetry. Results: Group A patients had a postoperative 3rd-month maximum flow rate value of 16.09 ml/s, whereas this same parameter was 15.15 ml/s in group B (p < 0.05). The urethral stricture recurrence rate up to the 9-month period was statistically significant for group A (14%) compared with group B (30%). When we compared the recurrence rates of these groups from postoperative day 1 up to the 18th month, the results were 37% for group A and 33% for group B (p > 0.05). Conclusion: PlasmaKinetic urethrotomy provides a better recurrence-free rate during the early period compared with conventional cold knife therapy. Nevertheless, the outcome of the stricture did not change and fibrotic tissue reformed between the 9th and the 18th month.

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Comparative Healing of Human Cutaneous Surgical Incisions Created by the PEAK PlasmaBlade, Conventional Electrosurgery, and a Standard Scalpel

Abstract: Therapeutic, II.(Figure is included in full-text article.).

Cited by 78 publications

References 20 publications

Preclinical Comparison of Thermal Tissue Effects from Traditional Electrosurgery and a Low-Temperature Electrosurgical Device during Anterior Cervical Discectomy and Fusion

Preclinical Comparison of Thermal Tissue Effects from Traditional Electrosurgery and a Low-Temperature Electrosurgical Device during Anterior Cervical Discectomy and Fusion

Comparison of Electrocautery and Plasmablade on Ischemia and Seroma Formation after Modified Radical Mastectomy for Locally Advanced Breast Cancer

PlasmaKinetic™ versus Cold Knife Internal Urethrotomy in Terms of Recurrence Rates: A Prospective Randomized Study

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