Comparative healing of XXXX fascia following incision with three surgical instruments.

@entity35 @entity4438 @entity547
BACKGROUND: Incisional @entity547 and @entity4438 dehiscence are associated with significant postoperative morbidity. Electrosurgical devices using pulsed radiofrequency energy and a novel electrode design markedly reduce thermal injury during cutting and coagulation while maintaining equal surgical performance. In this study, we examine @entity4438 healing dynamics in a @entity35 model following incision with a pulsed radiofrequency energy device (PRE), a conventional electrosurgical device, and a standard "cold" scalpel. We hypothesize that incisions made with the pulsed radiofrequency energy device will result in a superior @entity4438 healing profile compared with conventional electrosurgery. MATERIALS AND METHODS: Full thickness surgical incisions were created in @entity35 fascia using a commercially available PRE device, conventional electrosurgery, and a scalpel. Harvested @entity4438 specimens were analyzed for burst strength testing and healing-associated histologic characteristics at d 7, 14, 21, and 42. RESULTS: PRE incisions were fully healed by 6 wk with normal tissue architecture. By all measures, wounds created by the PRE device were comparable to those made with the standard scalpel. Compared with PRE, conventional electrosurgery incisions exhibited a larger zone of tissue injury (68% greater in Coag mode, P < 0.0001; 46% greater in Cut mode, P < 0.001), an increased inflammatory response and a less favorable wound architecture. In the immediate postoperative period (1 wk), burst strength testing demonstrated that @entity4438 were significantly stronger than those made by electrosurgery in Coag mode (318%, P = 0.001). CONCLUSIONS: The favorable @entity4438 healing profile of the PRE device suggests that it is a promising new surgical technology. The early improved strength of wounds made with this device is of particular interest, as wound dehiscence is of greatest concern early in the healing process.
