Baba Shiro, Matsuo Takayuki, Ushijima Ryujiro, Yano Hiroki, Suyama Kazuhiko, Nagata Izumi
Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
No Shinkei Geka. 2010 Jun;38(6):539-44.
The steel scalpel and scalp clips have been commonly used for scalp incision in many neurosurgical procedures. Electrocautery is used mainly for subcutaneous and deep-layer dissection. The use of electrocautery on scalp incision has been avoided because of possible adverse events such as wound dehiscence and infection. We report our experience in Colorado-microdissection needle electrocautery for scalp incisions performed in our institution between November, 2006 and March, 2009. The rate of wound infection was compared in patients using the microdissection needle (100 procedures, n=93) and those using the steel scalpel/clips (n=261) during the same period. In patients using the microdissection needle, wound healing delay was not observed. Wound infection developed in only one procedure (1.0%) with the microdissection needle, and it developed in 6 procedures (2.2%) with the steel scalpel/clips, although this did not reach statistical significance (p=0.34). The use of electrocautery tended to cause little tissue distortion during fine dissection and it reduced blood loss. In conclusion, Colorado-microdissection needle electrocautery for scalp incisions could be safe and quite useful in neurosurgical procedures.
在许多神经外科手术中,钢质手术刀和头皮夹常用于头皮切口。电灼主要用于皮下和深层解剖。由于可能出现伤口裂开和感染等不良事件,头皮切口一般不使用电灼。我们报告了2006年11月至2009年3月期间在本机构使用科罗拉多微解剖针电灼进行头皮切口的经验。比较了同期使用微解剖针的患者(100例手术,n = 93)和使用钢质手术刀/头皮夹的患者(n = 261)的伤口感染率。在使用微解剖针的患者中,未观察到伤口愈合延迟。使用微解剖针的手术中仅1例(1.0%)发生伤口感染,使用钢质手术刀/头皮夹的手术中有6例(2.2%)发生伤口感染,尽管这未达到统计学显著性(p = 0.34)。在精细解剖过程中,使用电灼往往只会引起轻微的组织变形,并且减少了失血。总之,科罗拉多微解剖针电灼用于头皮切口在神经外科手术中可能是安全且非常有用的。