Comparative healing of swine skin following incisions with different surgical devices

Abstract

Background: Electrosurgical technology is widely used in surgical dissection and hemostasis, but the generated heat creates thermal injury to adjacent tissues and delays wound healing. The plasma blade (PB) applies pulsed radiofrequency (RF) to generate electrical plasma along the edge of a thin, flat, insulated electrode, minimizing collateral tissue damage. This study aimed to evaluate wound healing in swine skin following incision with a new surgical system that applies low-temperature plasma (NTS-100), a foreign PB, conventional electrosurgery (ES), and a scalpel blade.Methods: In vitro porcine skin and an in vivo porcine skin model were used in this study. Full-thickness skin incisions 3 cm in length were made on the dorsum of each animal for each of the 5 surgical procedures at 0, 21, 28, 35, and 42 days. The timing of the surgical procedures allowed for wound-healing data points at 1, 2, 3, and 6 weeks accordingly. Local operating temperature and blood loss were quantified. Wounds were harvested at designated time points, tested for wound tensile strength, and examined histologically for scar formation and tissue damage. Results: Local operating temperature was reduced significantly with NTS-100 (cut mode 83.12±23.55 ℃; coagulation mode 90.07±10.6 ℃) compared with PB (cut mode 94.46±11.48 ℃; coagulation mode 100.23±6.58 ℃, P<0.05) and ES (cut mode 208.99±34.33 ℃, P<0.01; coagulation mode 233.37±28.69 ℃, P<0.01) in vitro. Acute thermal damage from NTS-100 was significantly less than ES incisions (cut mode: 247.345±42.274 versus 495.295±103.525 μm, P<0.01; coagulation mode: 351.419±127.948 versus 584.516±31.708 μm, P<0.05). Bleeding, histological scoring of injury, and wound strength were equivalent for the NTS-100 and PB incisions. Conclusions:The local operating temperature of NTS-100 was lower than PB, and NTS-100 had similarly reliable safety and efficacy.

Smoke analysis of a new surgical system that applies low-temperature plasma

“…The PB is reported to perform better than the ES in terms of wound healing and duration time for procedures such as tonsillectomy, breast reconstruction, the replacement of implanted medical devices, and surgical debridement of chronic ulcers (4,22,23). Previous research has also confirmed that the NTS-100 is superior to the most developed PB in terms of the number of tissue injuries and its cutting and coagulating capability (24), and the NTS-100 has already been used effectively in breast, head and neck, and general surgery. Our findings illustrate that the NTS-100 generated substantially less hazardous surgical smoke than did the PB or the ES.…”