Blade Incisions Research Articles

Healing comparison of porcine cutaneous incisions made with cold steel scalpel, standard electrosurgical blade, and a novel tissue dissector.

Background:Standard electrosurgery provides superior hemostasis compared to a cold steel scalpel, but inferior tissue healing. A novel electrosurgical blade with an advanced waveform, the MEGADYNE ACE BLADE™ 700 Soft Tissue Dissector (ACE), was designed to provide both excellent hemostasis and wound healing. This study compared ACE to scalpel and standard electrosurgery in a porcine model of wound healing.Methods:Skin incisions from six pigs were evaluated at time points of 0, 1, 2, 3 and 6 weeks after application of the three devices. Histopathology was performed on samples from each time point. For each non-initial time point, the healing incisions were photographed for later evaluation by expert graders, and excised for wound strength testing.Results:Time 0 photomicrographs showed a gradient of thermal tissue damage by initial incision, ranging from no damage made by the scalpel, minimal damage made by ACE, and twice the ACE damage made by a nonstick PTFE-coated electrosurgical blade. Histopathologic analysis at 6 weeks showed comparable dermal scar width measurements for scalpel and ACE incisions. Scars were wider for incisions made by standard electrosurgical blade. Wound strength was greater for scalpel and ACE than for standard electrosurgery. Cosmetic results at 6 weeks were not significantly different between scalpel and ACE incisions, while standard electrosurgical blade incisions were significantly inferior to ACE (odds ratio: 53.4, p<0.001).Conclusion:The MEGADYNE ACE BLADE™ 700 Soft Tissue Dissector represents a significant improvement in electrosurgical technology for skin incisions and dispels the traditional concerns of delayed healing and poor cosmetic result that have been attributed to using conventional electrosurgical blades for skin incisions.

Tenderizing effect of blade tenderizer and pomegranate fruit products in goat meat

Toughness of goat meat is a major problem with regard to consumer acceptance. Keeping this in view a blade tenderizer was developed for tenderization of goat meat. Pomegranate fruit products were also explored for tenderization effect on goat meat. Tenderization of goat meat with pomegranate seed powder improved the textural properties marginally with slight adverse colour change and taste. Samples treated with PRP got lower score for colour in sensory evaluation and there was adverse effect on taste of treated meat. Blade tenderization and 4% PSP proved better for tenderization and were compared with control and 0.2% papain in goat meat chunks. The cooked samples treated with papain and blade incisions got better sensory scores and required lesser shear force compared to 4% PSP and control. Overall the papain treated meat was superior in terms sensory attributes followed by blade incision and PSP. The results suggested that the blade incisions can be used for tenderization of goat meat. Pomegranate seed powder maybe considered for mixing with other spices to marinate goat meat mainly for its beneficial effects.

Comparison Between Co2Laser and 4.0 MHz Radiosurgery for Incising Skin in White Carneau Pigeons (Columba Livia)

To objectively evaluate the collateral damage associated with radiosurgical and carbon dioxide (CO2) laser devices, a comparative surgical and histologic study was undertaken in white Carneau pigeons (Columba livia). Ten pigeons were anesthetized, and a series of 3 skin incisions were made in the pectoral region by using a 4.0-MHz radiosurgical unit, a CO2 laser, and a scalpel blade (control). A total of 90 skin incisions were microscopically evaluated, and their associated mechanical- and thermal-induced tissue lesions were measured in micrometers. Scalpel incisions invariably resulted in hemorrhage, whereas all laser and radiosurgical skin incisions were essentially bloodless. Scalpel blade incisions were least traumatic (mean [SD] 18 +/- 15 microm) followed by incisions created with radiosurgery (mean [SD] 94 +/- 60 microm) and CO2 laser (mean [SD] 150 +/- 64 microm). Radiosurgery was significantly less traumatic than CO2 laser (P = .003). Radiosurgery appears to offer significant benefits over CO2 laser for avian surgery.

Ultrastructure of clear corneal incisions: Part I: Effect of keratomes and incision width on corneal trauma after lens implantation

Purpose: To examine the ultrastructure of clear corneal incisions (CCls) performed with diamond keratomes and steel blades as well as the corneal trauma after implantation of a foldable intraocular lens (IOL) through two incision widths.Setting: University Eye Clinic and Institute of Histology and Embryology II, University of Vienna, Austria.Methods: Twenty-four human cadaver eyes without prior ocular surgery were obtained from the University Eye Bank, Vienna. Single-plane CCIs were performed with 3.0 and 3.2 mm Alcon steel blades and with a 3.0 mm Huco diamond keratome. The AVIO PhacoFlex II lens was implanted with a Fine II folder. During the entire procedure, the eye pressure was kept between 26 and 30 mm Hg by infusing balanced salt solution into the anterior chamber. Specimens were prepared for light microscopy, transmission electron microscopy, and scanning electron microscopy according to standard procedures.Results: The diamond keratome produced cleaner cuts than the steel blade. After IOL implantation, 3.0 mm steel blade incisions exhibited extensions at their lateral ends. Within these extensions, the collagen lamellae were displaced and torn. This was not true with 3.2 mm tunnels. Because of the thickness of a 3.0 mm diamond keratome, the extent of corneal trauma was between that found with 3.0 and 3.2 mm steel keratome tunnels.Conclusions: Implantation of the SI-30 through 3.0 mm CCls produced by the steel blade led to more severe corneal trauma than implantation through 3.2 mm steel blade incisions or 3.0 mm diamond keratome incisions. Thus, IOL implantation through incisions that are too small intensifies corneal trauma.

Ultrastructure of clear corneal incisions: Part II: Corneal trauma after lens implantation with the Microstaar injector system

Purpose: To examine the ultrastructure of clear corneal incisions (CCls) after implantation of a plate-haptic intraocular lens (IOL) with the Microstaar™ injector system through two incision widths.Setting: University Eye Clinic and Institute of Histology and Embryology II; University of Vienna, Austria.Methods: Fourteen human cadaver eyes without prior ocular surgery were obtained from the University Eye Bank, Vienna. Single-plane CCls were performed with 3.0 and 3.2 mm steel keratomes. Using the Microstaar injector system, a foldable silicone plate-haptic IOL (23 diopters) was implanted in the anterior chamber. During the entire procedure, the eye pressure was kept between 26 and 30 mm Hg by infusing balanced salt solution into the anterior chamber. Specimens for light microscopy and scanning electron microscopy were prepared according to standard procedures.Results: After IOL implantation, the 3.0 mm steel blade incisions exhibited distinct distensions at their lateral ends. Adjacent to these distensions, the collagen lamellae were pressed apart, displaced, and torn. In 3.2 mm tunnels, the corneal trauma at both lateral ends was considerably less severe. These incisions also showed a better primary adaptation of the wound lips after implantation.Conclusions: Implantation performed with the Microstaar injector system through 3.0 mm steel blade CCIs led to considerably more severe corneal trauma than implantation through 3.2 mm incisions.

Use of a stencil for improved accuracy, speed, and aesthetic results in mini-micrografting.

Two stencils have been developed that improve the accuracy, speed, and aesthetic of mini-micrografting. The stencil most frequently used is for #15 blade incisions (six- to eight-haired minigrafts); the other is for 1.0-2.0-mm holes (three- to four-haired minigrafts). The slit stencil has 20 recipient sites per square inch; the hole stencil has 40. To improve accuracy, speed, and aesthetic results of mini-micrografting. The areas to be incised are markedly preoperatively, utilizing a stencil, which develops a very precise pattern. The slits or holes can then be made very quickly and accurately over these marks. Because bleeding does not obscure the markings, the speed, precision, and the results of the procedures are greatly enhanced. The use of stencil improved the accuracy, speed, and aesthetic results of the mini-micrografting procedure. It also helps the surgeon accurately predict the number of minigrafts that will be needed for a specific area.

Utilization of No-Kor needles for slit-micrografting.

This article introduces the No-Kor vented needle as an excellent tool for micrograft recipient site development. To show that No-Kor vented needles are better than conventional hypodermic needles (with and without dilators) and Bard Parker blades for micrograft recipient site development. Comparisons with hypodermic needles (with and without dilators) and Bard Parker blade incisions are made. When compared with hypodermic needles (with and without dilators, the No-Kor needles show less scarring, allow easier placement, take less surgical time, and are less expensive. When compared with Bard Parker blade incisions, the No-Kor needles demonstrate less scarring, more precision, and less expense. The No-Kor vented needle is an excellent tool for the development of micrograft recipient sites. It demonstrates advantages over both hypodermic needles and Bard Parker blades.

Correction of astigmatism with the Excimer laser

Excimer laser corneal T-excisions for the correction of astigmatism in eight eyes followed up for three months postoperatively revealed an effective change in refraction of up to 4.2 diopters. The effect depends on the depth of the excision. Although the clinical results agree with astigmatism theory predictions from a biomechanical model of the cornea, some features are not explained by the model. The temporal behavior of the changes in refraction subsequent to excimer laser excisions differ from those produced by blade incisions, indicating a different repair mechanism. The keratectomy technique employed did not result in any serious side effects.