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Torres-Augusto Neto R, Comachio CA, de Almeida LCQ, de Azambuja Carvalho PH, Dos Santos Trento G, Pereira-Filho VA. Tissue response to different incision tools in animal model. Oral Maxillofac Surg 2023; 27:631-638. [PMID: 35915281 DOI: 10.1007/s10006-022-01105-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 07/26/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study is to compare the repair of incisions performed with microdissection electrocautery tip, conventional electrocautery tip, high potency diode laser, and conventional scalpel blade in a in vivo model. METHODS Different incisions were performed in adults Holtzman rats using the four types of instruments: microdissection electrocautery tip, conventional electrocautery tip, high potency diode laser, and conventional scalpel blade, in different periods of healing process. Thirty rats were divided into 5 groups, according to the period of euthanasia-24 h, 48 h, 72 h, 7 days, and 14 days. All animals received four incisions, each by a different method. Quantitative histological and histomorphometric analyses were performed using hematoxylin and eosin (HE) and Picrosirius Red staining. RESULTS Inflammatory profile and tissue repair presented small statistically significance differences comparing conventional scalpel blade and microdissection tip; moreover, both presented quantitatively superior to the others. CONCLUSION It is believed that the microdissection tip can perform a dynamic incision just as a common scalpel blade, but more effective. Furthermore, it can promote a better hemostatic control of the surgical field that is comparable to conventional electrocautery tip without affecting tissue repair.
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Affiliation(s)
- Renato Torres-Augusto Neto
- School of Dentistry, Araraquara - Diagnosis and Surgery Department, São Paulo State University (UNESP), Rua Humaitá, 1680 - Centro - Araraquara, Araraquara, SP, 14801-903, Brazil.
| | - Cássio Amaro Comachio
- School of Dentistry, Araraquara - Diagnosis and Surgery Department, São Paulo State University (UNESP), Rua Humaitá, 1680 - Centro - Araraquara, Araraquara, SP, 14801-903, Brazil
| | - Lilian Caldas Quirino de Almeida
- School of Dentistry, Araraquara - Diagnosis and Surgery Department, São Paulo State University (UNESP), Rua Humaitá, 1680 - Centro - Araraquara, Araraquara, SP, 14801-903, Brazil
| | - Pedro Henrique de Azambuja Carvalho
- School of Dentistry, Araraquara - Diagnosis and Surgery Department, São Paulo State University (UNESP), Rua Humaitá, 1680 - Centro - Araraquara, Araraquara, SP, 14801-903, Brazil
| | - Guilherme Dos Santos Trento
- School of Dentistry, Araraquara - Diagnosis and Surgery Department, São Paulo State University (UNESP), Rua Humaitá, 1680 - Centro - Araraquara, Araraquara, SP, 14801-903, Brazil
| | - Valfrido Antônio Pereira-Filho
- School of Dentistry, Araraquara - Diagnosis and Surgery Department, São Paulo State University (UNESP), Rua Humaitá, 1680 - Centro - Araraquara, Araraquara, SP, 14801-903, Brazil
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Oksa M, Haapanen A, Marttila E, Furuholm J, Snäll J. Postoperative wound dehiscence in mandibular fractures. Acta Odontol Scand 2023; 81:555-561. [PMID: 37171859 DOI: 10.1080/00016357.2023.2211156] [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: 02/05/2023] [Accepted: 05/02/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVE To clarify the occurrence and causes of non-infection-related surgical wound dehiscence (SWD) in intraorally treated mandibular fractures. MATERIAL AND METHODS Patients with one or two fractures of the dentate part of the mandible treated surgically via an intraoral approach were included in this retrospective study. The primary outcome variable was SWD. Associations between patient-, fracture- and surgery-related variables and SWD were evaluated. RESULTS Altogether 232 patients with 270 mandibular angle, body, symphysis and/or parasymphysis fractures were included in the analysis. In all, 22 SWDs were detected. These occurred in 9.5% of patients and in 8.1% of fractures. Surgery performed at night-time showed a significantly higher SWD rate than daytime surgeries (p = .012). Additionally, a significantly greater SWD rate was found among smokers (p = .041). Other studied variables remained statistically non-significant for SWD. In a multivariate analysis, night-time was the only significant independent variable with an odds ratio of 3.297 (95% CI 1.238 - 8.780, p = .017) for SWD. CONCLUSION The approach or closure technique used and the fracture type had only a minor effect on non-infection-related SWD in patients with mandibular fractures. To avoid SWDs, mandibular fracture surgeries should be conducted during the daytime with adequate support from an experienced surgeon.
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Affiliation(s)
- Marko Oksa
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland, and Helsinki University Hospital, Helsinki, Finland
| | - Aleksi Haapanen
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland, and Helsinki University Hospital, Helsinki, Finland
| | - Emilia Marttila
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland, and Helsinki University Hospital, Helsinki, Finland
| | - Jussi Furuholm
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland, and Helsinki University Hospital, Helsinki, Finland
| | - Johanna Snäll
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland, and Helsinki University Hospital, Helsinki, Finland
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Hajilo P, Imani B, Zandi S, Mehrafshan A. Comparing the intraoperative and postoperative complications of the scalpel and electrocautery techniques for severing the inner layers of the lumbar disc during discectomy surgery. Front Surg 2023; 10:1264519. [PMID: 37841816 PMCID: PMC10568066 DOI: 10.3389/fsurg.2023.1264519] [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: 07/20/2023] [Accepted: 08/21/2023] [Indexed: 10/17/2023] Open
Abstract
Background Due to the sensitivity of the surgical site and a higher probability of injury, the use of a scalpel and electrocautery to create an incision in the spine is discussed. In this study, we will compare the intraoperative and postoperative complications of the scalpel and electrocautery techniques for severing the inner layers of the lumbar disc during discectomy surgery. Materials and methods This study was conducted in Iran as a randomized controlled trial with double-blinding (1,401). Sixty candidates for spine surgery were randomly divided into two groups of 30 using electrocautery (A) and a scalpel (B) based on available sampling. The VAS scale was used to assess postoperative pain. The duration of the incision and intraoperative blood loss were recorded. The infection and fluid secretions were determined using the Southampton scoring scale. Utilizing the Manchester scar scale, the wound healing status was evaluated. The SPSS version 16 software was used for data analysis (t-test, Mann-Whitney U, ANOVA). Results The electrocautery group had substantially lower bleeding, pain, and wound healing rates than the scalpel group (P > 0.05). However, the electrocautery group had significantly longer surgical times, more secretions, and a higher infection rate than the scalpel group (P > 0.05). In terms of demographic and clinical characteristics, there was no significant difference between the two groups (P < 0.05). Conclusion Electrocautery reduces postoperative hemorrhage and, potentially, postoperative pain in patients. However, as the duration of surgery increases, so does the duration of anesthesia, and patient safety decreases. Additionally, the risk of infection increases in the electrocautery group compared to the scalpel group, and the rate of wound healing decreases. Clinical Trial Registration https://www.irct.ir/, identifier (IRCT20230222057496N1).
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Affiliation(s)
- Parisa Hajilo
- Student Operating Room, Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Behzad Imani
- Department of Operating Room, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shirdel Zandi
- Department of Operating Room, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Mehrafshan
- Department of Neurosurgery, Nekuii Forghani Hospital University of Medical Sciense Qom, Qom, Iran
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Warshavsky A, Shivatzki S, Kampel L, Leider-Trejo L, Shapira U, Muhanna N, Ungar OJ, Fliss DM, Kaplan I, Horowitz G. The Effect of Diathermy Power Settings on Oral Cavity Mucosal Contraction: A Rat Model. Laryngoscope 2020; 131:E1514-E1518. [PMID: 33016337 DOI: 10.1002/lary.29155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/19/2020] [Accepted: 09/16/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS The effects of different electrocautery power settings on mucosal contraction and margin status in the oral cavity have not been well established. The aim of this study was to examine how different levels of electrocautery energy outputs affect oral mucosal tissue margins. STUDY DESIGN Animal model. METHODS A model of 23 adult rats was used (two specimens per rat). After anesthetizing the animals, a 6-mm biopsy punch marked the resection margin on the buccal mucosa (one per cheek). The specimens were excised by means of three energy levels, a cold knife, and monopolar diathermy that was set on either 20 W or 30 W cut modes. The specimens were evaluated for extent of contraction. RESULTS A total of 45 samples were obtained and measured, including 15 specimens in the cold-knife group, 15 specimens in the 20 W group, and 15 specimens in the 30 W group. The median diameters of the specimens after resection were 4.5 mm for the cold-knife group (interquartile range [IQR] = 4.0-5.0), 3.5 mm for the 20 W group (IQR = 3.5-4.0), and 2.8 mm for the 30 W group (IQR = 2.5-3.0). Specimen contraction was 25.0%, 41.7%, and 53.3%, respectively. The difference in shrinkage between each pair was statistically significant: cold knife versus 20 W, P = .001; cold knife versus 30 W, P < .0001; and 20 W versus 30 W, P < .001. CONCLUSIONS Diathermy power settings result in a significant difference of mucosal tissue contraction, with higher outputs resulting in a narrower mucosal margin. It is imperative that the surgical team take into consideration the diathermy settings during initial resection planning. Laryngoscope, 131:E1514-E1518, 2021.
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Affiliation(s)
- Anton Warshavsky
- Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Shaked Shivatzki
- Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Liyona Kampel
- Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Leonor Leider-Trejo
- Tel Aviv Sourasky Medical Center, Institute of Pathology, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Udi Shapira
- Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Nidal Muhanna
- Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Omer J Ungar
- Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Dan M Fliss
- Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ilana Kaplan
- Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Gilad Horowitz
- Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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