Gelman C L, Barroso E G, Britton C T, Haklin M F, Staren E D
Rush Presbyterian-St. Luke's Medical Center, Chicago, Ill.
Plast Reconstr Surg. 1994 Nov;94(6):829-33. doi: 10.1097/00006534-199411000-00012.
This study evaluated the technical ease and wound-healing response of cutaneous flaps constructed on dogs using Nd:YAG laser, CO2 laser, electrocautery, and sharp dissection. Four flaps were constructed on the dorsum of 16 dogs using each of the four modalities. Parameters examined included drainage after both 48 hours and 1 week, time of dissection, bursting strength, and semiquantitative assessments of fibroblast, polymorphonuclear leukocyte, monocyte, and collagen content. Significantly less time was required to construct flaps with electrocautery as compared with CO2 laser, Nd:YAG laser, and sharp dissection (15 versus 18, 20, and 26 minutes, respectively; p < 0.01). Significantly fewer suture ligatures were necessary to obtain hemostasis for electrocautery, CO2 laser, and Nd:YAG laser as compared with sharp dissection (0, 2, and 2 versus 15 sutures, respectively; p < 0.01). Drainage was significantly less for flaps constructed using sharp dissection as compared with both CO2 and Nd:YAG lasers at 48 hours (12 versus 26 cc, p < 0.01, and 20 cc, p < 0.05, respectively). Significantly less drainage was observed after 48 hours for flaps created using electrocautery as compared with CO2 laser (14 versus 26 cc; p < 0.05). Bursting strength of flaps constructed using sharp dissection was significantly greater than that of those constructed using electrocautery, Nd:YAG laser, and CO2 laser (1086 versus 638 gm, p < 0.05, 714 gm, and 571 gm, p < 0.01, respectively). Semiquantitative histologic evaluation revealed a higher collagen content and fibroblast infiltration and less polymorphonuclear leukocyte infiltration in wounds created using sharp dissection as compared with CO2 laser, Nd:YAG laser, and electrocautery.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究评估了使用Nd:YAG激光、CO2激光、电灼术和锐性剥离在犬身上构建皮瓣的技术难易程度及伤口愈合反应。使用这四种方式中的每一种，在16只犬的背部构建四个皮瓣。检查的参数包括48小时和1周后的引流情况、剥离时间、抗张强度，以及对成纤维细胞、多形核白细胞、单核细胞和胶原含量的半定量评估。与CO2激光、Nd:YAG激光和锐性剥离相比，用电灼术构建皮瓣所需时间显著更少（分别为15分钟对18、20和26分钟；p<0.01）。与锐性剥离相比，用电灼术、CO2激光和Nd:YAG激光实现止血所需的缝合结扎显著更少（分别为0、2和2对15针；p<0.01）。在48小时时，与CO2激光和Nd:YAG激光相比，使用锐性剥离构建的皮瓣引流显著更少（分别为12毫升对26毫升，p<0.01，和20毫升，p<0.05）。与CO2激光相比，用电灼术构建的皮瓣在48小时后引流显著更少（14毫升对26毫升；p<0.05）。使用锐性剥离构建的皮瓣抗张强度显著大于用电灼术、Nd:YAG激光和CO2激光构建的皮瓣（分别为1086克对638克，p<0.05，714克和571克，p<0.01）。半定量组织学评估显示，与CO2激光、Nd:YAG激光和电灼术相比，使用锐性剥离造成的伤口中胶原含量更高且成纤维细胞浸润更多，但多形核白细胞浸润更少。（摘要截短于250字）
