Sheikh B
Neurosurgery Department, King Faisal University, Saudi Arabia.
Br J Neurosurg. 2004 Jun;18(3):268-72. doi: 10.1080/02688690410001732715.
Diathermy is used widely in neurosurgical procedures, mainly for subcutaneous and deeper layers dissection. The use on scalp and skin of other body parts has been precluded by the fear of scar formation and wound dehiscence. One-hundred-and-seventy-seven skin incisions for neurosurgical procedures have been performed using the micro-needle electrocautery scalpel (MES) and the steel scalpel. The elements in this study included: electrocautery generator unit, cutting mode, power, waveform, size and shape of the MES, depth of the incision, the speed of the electrode movement through tissue, amount of blood loss, physical inspection of the wound edges and wound complication. Patients tolerated the procedures well, with no increased risk from the use of the MES. Only two incisions had wound infection and dehiscence. All other patients had usual wound healing. Time taken during skin opening was significantly shorter when using the MES. Blood loss during skin opening was three to five times less when the micro-needle electrocautery scalpel was used. The MES is both safe and useful in neurosurgical procedures. The findings of this study recommend the use of the MES in all neurosurgical procedures, especially when blood loss has significant importance, such as in paediatric cases.
透热疗法在神经外科手术中被广泛应用，主要用于皮下及更深层组织的解剖。由于担心形成瘢痕和伤口裂开，头皮及身体其他部位皮肤的应用受到限制。使用微针电灼手术刀（MES）和钢质手术刀进行了177例神经外科手术的皮肤切口。本研究的要素包括：电灼发生器单元、切割模式、功率、波形、MES的尺寸和形状、切口深度、电极在组织中移动的速度、失血量、伤口边缘的体格检查及伤口并发症。患者对手术耐受良好，使用MES未增加风险。仅有两例切口出现伤口感染和裂开。所有其他患者伤口愈合正常。使用MES时皮肤切开所用时间显著缩短。使用微针电灼手术刀时皮肤切开期间的失血量减少三至五倍。MES在神经外科手术中既安全又有用。本研究结果建议在所有神经外科手术中使用MES，尤其是在失血量至关重要的情况下，如儿科病例。
