Papay F A, Stein J, Luciano M, Zins J E
Department of Plastic and Reconstructive Surgery, Cleveland Clinic Foundation, OH 44195, USA.
J Craniofac Surg. 1998 Jul;9(4):344-7. doi: 10.1097/00001665-199807000-00010.
Craniofacial procedures commonly use scalp incisions to optimize surgical access and aesthetic results. Although the use of traditional electrocautery instruments on hair-bearing tissue has been limited secondary to the width of resulting alopecia, needle-tipped electrocautery devices with decreased energy transmission have been developed. This study investigates the cosmetic effect of such instruments on scalp incisions. Twelve children undergoing craniosynostotic correction via bicoronal incisions were included. One side of the incision was completed with the cold scalpel whereas the contralateral portion was effected using the Colorado MicroDissection Needle (Colorado Biomedical Inc., Evergreen, CO, U.S.A.) according to optimal usage instructions. At the conclusion of the study period, precise measurements of the resultant width of alopecia were obtained from the parietal and temporal regions bilaterally, and were analyzed statistically. Also, parents completed a questionnaire concerning subjective observations of the surgical incision and its healing. The portions of the incision completed with the Colorado MicroDissection Needle demonstrated a wider area of peri-incisional alopecia (5.8 +/- 1.8 mm) than that produced by the cold scalpel (3.5 +/- 0.87 mm). Not only was this increased width significant statistically (P < 0.05), in addition the disparity was noted by the majority of parents (10 of 12) either on the patient questionnaire or with nonsuggestive verbal questioning. The benefit of the hemostatic incisional technique of electrocautery with even needle-tipped instruments must be weighed carefully against its cosmetic consequences.
颅面手术通常采用头皮切口，以优化手术入路和美学效果。尽管传统电灼器械在有毛发组织上的使用因术后脱发宽度而受到限制，但已开发出能量传输减少的针尖状电灼设备。本研究调查了此类器械对头皮切口的美容效果。纳入了12例通过双冠状切口进行颅缝早闭矫正的儿童。切口的一侧用冷手术刀完成，而对侧部分则根据最佳使用说明使用科罗拉多微型解剖针（美国科罗拉多州埃弗格林市科罗拉多生物医学公司）进行操作。在研究期结束时，从双侧顶叶和颞叶区域精确测量脱发后的宽度，并进行统计学分析。此外，家长们填写了一份关于手术切口及其愈合主观观察的问卷。用科罗拉多微型解剖针完成的切口部分显示，切口周围脱发区域（5.8±1.8毫米）比冷手术刀造成的脱发区域（3.5±0.87毫米）更宽。不仅这种增加的宽度在统计学上具有显著性（P<0.05），而且大多数家长（12名中的10名）在患者问卷或无暗示性口头询问中都注意到了这种差异。必须仔细权衡使用带均匀针尖器械的电灼止血切口技术在美容方面的后果。
