Pearce Elizabeth C, Hall Joseph E, Boyd Kelli L, Rousseau Bernard, Ries W Russell
Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Otolaryngol Head Neck Surg. 2014 Sep;151(3):424-30. doi: 10.1177/0194599814536699. Epub 2014 May 27.
We tested the hypothesis that the ophthalmology microscalpel, compared to standard incisional instruments, causes less trauma during incisions resulting in decreased inflammation and greater tensile strength of wounds.
Prospective animal study.
Animal laboratory.
Thirty-four Sprague-Dawley rats received dorsum skin incisions with the microscalpel, electrosurgical device, 11 blade scalpel, and 15 blade scalpel. Wounds were harvested at 1 week, 2 weeks, 3 weeks, and 6 weeks, then analyzed histologically in a blinded manner for inflammation markers and tested for tensile strength.
The microscalpel wounds had significantly higher tensile strength compared to the 15 blade (P = .045) and electrocautery device (P = .000) but equivocal strength to the 11 blade (P = .457). The electrocautery wounds were weaker than all 3 steel blades. No significant difference was found between the microscalpel, 11 blade, and 15 blade incisions for the 5 markers of inflammation. Electrocautery wounds had significantly worse inflammatory scores, specifically, higher angiogenesis and larger wound gap compared to the microscalpel (P = .004, P = .002), 11 blade (P = .007, P = .023), and 15 blade (P = .010, P = .003), respectively.
Microscalpel incisions result in less inflammation and increased tensile strength compared with electrocautery and higher tensile strength compared to the 15 blade in the rat model. Inflammation scores were equivocal between the microscalpel, 11 blade, and 15 blade. Our findings support the use of the microscalpel blade for facial plastic and reconstructive procedures. Prospective, randomized human studies are warranted.
我们检验了这样一个假设,即与标准切开器械相比,眼科微型手术刀在切开过程中造成的创伤更小,从而导致炎症减轻且伤口的抗张强度更大。
前瞻性动物研究。
动物实验室。
34只斯普拉格-道利大鼠接受了使用微型手术刀、电外科设备、11号刀片手术刀和15号刀片手术刀进行的背部皮肤切开。在1周、2周、3周和6周时采集伤口,然后以盲法进行组织学分析以检测炎症标志物,并测试抗张强度。
与15号刀片(P = 0.045)和电灼设备(P = 0.000)相比,微型手术刀造成的伤口具有显著更高的抗张强度,但与11号刀片相比抗张强度相当(P = 0.457)。电灼造成的伤口比所有3种钢制刀片造成的伤口都更脆弱。在微型手术刀、11号刀片和15号刀片切开的伤口之间,5种炎症标志物未发现显著差异。与微型手术刀(P = 0.004,P = 0.002)、11号刀片(P = 0.007,P = 0.023)和15号刀片(P = 0.010,P = 0.003)相比,电灼造成的伤口炎症评分显著更差,具体而言,血管生成更高且伤口间隙更大。
在大鼠模型中,与电灼相比,微型手术刀切开造成的炎症更少且抗张强度增加,与15号刀片相比抗张强度更高。微型手术刀、11号刀片和15号刀片之间的炎症评分相当。我们的研究结果支持在面部整形和重建手术中使用微型手术刀刀片。有必要进行前瞻性、随机对照的人体研究。