Griffin Darvin J, Vijay Palaniswamy, Speltz Molly, Kirchhof Nicole, Vose Joshua G
Medtronic Transformative Solutions, Portsmouth, NH.
Medtronic ENT, Jacksonville, FL.
Wounds. 2017 Dec;29(12):374-379.
This study examines the healing dynamics of in vivo porcine muscle tissue wounds hemostatically treated with a saline-coupled bipolar tissue sealer (SCBS) compared with traditional electrosurgical (ES) coagulation.
Six cutaneous incisions were created on the dorsum of 28 adult male Yorkshire swine. The underlying muscle tissue was incised with a cold scalpel then treated with either SCBS (at 170 W) or traditional ES (at Coag 45 W). Time to hemostasis was recorded. Animals were humanely euthanized at day 2 and weeks 2, 3, or 8; treated tissue was harvested for histopathological evaluation.
After 8 weeks, the extent of wound healing was similar between SCBS and ES. Both devices controlled bleeding effectively; however, SCBS-treated wounds exhibited a greater depth of thermal effect over the first 3 weeks despite a shorter treatment time. Wounds treated with SCBS demonstrated fewer inflammatory markers at early time points but healed more slowly, with scores that lagged behind ES for collagen deposition, fibrous tissue maturity, extracellular matrix, and stage of healing. Myofiber regeneration notably increased in SCBS-treated wounds at weeks 2, 3, and 8. By the end of the 8-week recovery period, there were no significant differences in healing parameters between the 2 groups.
Overall, both devices elicited similar progression of healing by 8 weeks. The SCBS produced a deeper thermal effect in a shorter treatment time and improved myofiber regeneration compared with ES and had an equivalent overall course of healing.
本研究考察了用生理盐水耦合双极组织封闭器(SCBS)进行止血治疗的猪体内肌肉组织伤口与传统电外科(ES)凝固术相比的愈合动态。
在28只成年雄性约克夏猪的背部制作6个皮肤切口。用冷手术刀切开下方的肌肉组织,然后用SCBS(170瓦)或传统ES(凝固功率45瓦)进行治疗。记录止血时间。在第2天以及第2、3或8周对动物实施安乐死;采集处理过的组织进行组织病理学评估。
8周后,SCBS和ES治疗的伤口愈合程度相似。两种器械均能有效控制出血;然而,尽管SCBS治疗时间较短,但在最初3周内,其治疗的伤口热效应深度更大。SCBS治疗的伤口在早期炎症标志物较少,但愈合较慢,在胶原蛋白沉积、纤维组织成熟度、细胞外基质和愈合阶段方面的评分落后于ES。在第2、3和8周,SCBS治疗的伤口中肌纤维再生明显增加。到8周恢复期结束时,两组之间的愈合参数没有显著差异。
总体而言,两种器械在8周时引发的愈合进程相似。与ES相比,SCBS在更短的治疗时间内产生了更深的热效应,并改善了肌纤维再生,且总体愈合过程相当。