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Park H, Oh S, Kim YS, Spiro CL, Hong JP, Choi JW. Effects of an Ultra-Polished Scalpel on Incisional Wounds in a Diabetic Model. J Craniofac Surg 2024; 35:00001665-990000000-01298. [PMID: 38270441 PMCID: PMC10880936 DOI: 10.1097/scs.0000000000009955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 11/26/2023] [Indexed: 01/26/2024] Open
Abstract
Inflammation after surgical incisions is related to the degree of tissue damage. Healing with low inflammation is desirable, especially in patients with compromised healing potential. This experimental study was conducted to assess the degree of inflammatory reaction and scar formation from incisions made by an ultra-polished scalpel (UPS). Two paravertebral incisions were made with a conventional scalpel (CS) and a UPS in 18 individual rats with diabetes. The fibrotic tissue (scar) area and expression levels of collagen, transforming growth factor, and matrix metalloproteinases were quantified on postoperative days 3, 7, and 30. The scar widths and areas were significantly lower in the UPS group than in the CS group. The scar widths were 64.3 ± 14.7 µm and 86.8 ± 12.1 µm in the UPS and CS groups, respectively (P = 0.03). The scar areas were 11,398 ± 1595 µm2 in the UPS group and 17,433 ± 3487 µm2 in the CS group (P = 0.014). The UPS group had less inflammation on day 3, less transforming growth factor synthesis on days 3 and 7, lower levels of matrix metalloproteinases, and less collagen synthesis on day 7 than did the CS group. The UPS achieved less local inflammation by reducing the local tissue damage in diabetic rat models, enabling better healing, and resulting in less scar formation. The UPS warrants further clinical study as it may bring beneficial outcomes for patients with impaired healing capability and patients who seek to reduce scarring.
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Affiliation(s)
- Hojin Park
- Department of Plastic and Reconstructive Surgery, College of Medicine, Korea University, Korea University Anam Hospital
| | - Somin Oh
- Department of Plastic and Reconstructive Surgery, Seoul Asan Medical Center, College of Medicine, Ulsan University, Seoul, Republic of Korea
| | - Young Sam Kim
- Department of Plastic and Reconstructive Surgery, Seoul Asan Medical Center, College of Medicine, Ulsan University, Seoul, Republic of Korea
| | | | - Joon Pio Hong
- Department of Plastic and Reconstructive Surgery, Seoul Asan Medical Center, College of Medicine, Ulsan University, Seoul, Republic of Korea
| | - Jong Woo Choi
- Department of Plastic and Reconstructive Surgery, Seoul Asan Medical Center, College of Medicine, Ulsan University, Seoul, Republic of Korea
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Dai X, Zheng J, Yu X, Liu Z, Zheng L, Chen Z, Wang C. Mechanical properties and tissue damage caused by staples in gastrointestinal anastomosis. Proc Inst Mech Eng H 2024; 238:33-44. [PMID: 38156406 DOI: 10.1177/09544119231216283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2023]
Abstract
Gastrointestinal surgery using a stapler is usually associated with tissue damage, anastomosis leakage, bleeding, and other complications, which is one of the effective methods for treating digestive tract cancer. The cutting properties of staples and the tissue damage occurring in the process of stapling porcine esophageal and gastric tissues have been evaluated and a new type of stapler has been designed. Since different structural and mechanical properties esophageal and gastric tissues layers, the puncturing force exhibits a fluctuating trend. Compressive stress caused by the bending of the staple legs can lead to the destruction of the vascular network inside the tissue, tissue deforms and tears. Finally, a staple with an internal incision arc (IIA) tip is designed, which meeting the performance requirements.
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Affiliation(s)
- Xuan Dai
- School of Electro-Mechanical Engineering, Guangdong University of Technology, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Minimally Invasive Surgical Instruments and Manufacturing Technology, Guangdong University of Technology, Guangzhou, Guangdong, China
| | - Junjie Zheng
- School of Electro-Mechanical Engineering, Guangdong University of Technology, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Minimally Invasive Surgical Instruments and Manufacturing Technology, Guangdong University of Technology, Guangzhou, Guangdong, China
| | - Xiaoli Yu
- Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhihua Liu
- School of Electro-Mechanical Engineering, Guangdong University of Technology, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Minimally Invasive Surgical Instruments and Manufacturing Technology, Guangdong University of Technology, Guangzhou, Guangdong, China
- Zhuhai Ton-Bridge Medical Technology Co., Ltd., Zhuhai, Guangdong, China
| | - Lijuan Zheng
- School of Electro-Mechanical Engineering, Guangdong University of Technology, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Minimally Invasive Surgical Instruments and Manufacturing Technology, Guangdong University of Technology, Guangzhou, Guangdong, China
| | - Zhihua Chen
- School of Electro-Mechanical Engineering, Guangdong University of Technology, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Minimally Invasive Surgical Instruments and Manufacturing Technology, Guangdong University of Technology, Guangzhou, Guangdong, China
| | - Chengyong Wang
- School of Electro-Mechanical Engineering, Guangdong University of Technology, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Minimally Invasive Surgical Instruments and Manufacturing Technology, Guangdong University of Technology, Guangzhou, Guangdong, China
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