PEAK PlasmaBlade Research Articles

PlasmaBlade versus Electrocautery for Deep Inferior Epigastric Perforator Flap Harvesting in Autologous Breast Reconstruction: A Comparative Clinical Outcome Study.

(1) Background: DIEP-based breast reconstruction necessitates wide undermining at the abdominal donor site, creating large wound areas. Flap harvesting is usually conducted using electrosurgical dissection devices. This study sought to compare the clinical outcomes in patients after using the PEAK PlasmaBlade (PPB) versus monopolar electrocautery (MPE). (2) Methods: This retrospective cohort study included 128 patients with DIEP-based breast reconstruction. Patient characteristics and information on the postoperative course were collected and a comparative evaluation was conducted. (3) Results: The MPE group exhibited significantly (p* = 0.0324) higher abdominal drainage volume (351.11 ± 185.96 mL) compared to the PPB group (279.38 ± 183.38 mL). A subgroup analysis demonstrated that PPB significantly reduced postoperative wound fluid in patients with BMI > 30 kg/m2 (p* = 0.0284), without prior neoadjuvant chemotherapy (p** = 0.0041), and among non-smokers (p = 0.0046). Furthermore, postoperative pain was significantly (p**** < 0.0001) lower in the PPB cohort. (4) Conclusions: This study confirms the non-inferiority of the PEAK PlasmaBlade to conventional electrocautery for abdominal flap harvesting. The PPB demonstrated advantages, notably reduced drainage volume and lower postoperative pain levels. Recognizing patient subsets that benefit more from the PPB highlights the importance of personalized device selection based on patient characteristics.

Clinical application of PEAK PlasmaBlade to remove distal tracheal granulation in patients after tracheostomy

ObjectiveTracheal granulation is one of the common long term complications in patients after tracheostomy. Hypertrophic tracheal granulation may cause airway obstruction and further operation may be required to recreate an airway. Distal tracheal granulation is clinically challenging because of its position and surgical field limitation. This retrospective case review study evaluated the outcomes of PEAK PlasmaBlade-assisted tracheal surgery in patients with distal tracheal granulation. MethodsThis study retrospectively reviewed patients with distal tracheal granulation following long-term tracheostomy. All patients received PEAK PlasmaBlade assistance tracheal surgery (PATS) between February 2013 and December 2019. The surgery was performed using the PEAK PlasmaBlade with TnA type tip, powered by a PULSAR Generator, and guided by a 45 ° rigid endoscope. Patients were regularly followed up for a minimum of 12 months. ResultsA total 21 patients had completed PATS. None of the patients experience immediate life-threatening complications during or after the procedure. All the 21 patients were free of recurrent obstructive granulation within 12 months after operation. ConclusionPATS is practical, effective, and safe for distal tracheal granulation and can be performed by single surgeon. Furthermore, it is technically less demanding than other surgical approaches and it has a rapid learning curve.

Lead damage after cardiac implantable device replacement procedure: Comparison between electrical plasma tool and electrocautery.

Lead damage is a complication caused by lead manipulation or heating damage from conventional electrocautery (EC) after cardiovascular implantable electronic device (CIED) replacement. Application of electrical plasma (PEAK PlasmaBlade) is a new technology that reportedly reduces this risk. This study was designed to compare the effect of EC versus PEAK PlasmaBlade on lead parameters and complications after generator replacement procedures. We retrospectively studied 410 consecutive patients (840 leads) who underwent CIED replacement using EC (EC group) and 410 consecutive patients (824 leads) using PEAK PlasmaBlade (PlamaBlade group). Pacing lead impedance, incidence of lead damage, and complications were compared between both groups. Lead impedance increased in 393 leads (46.8%) in the EC group versus 282 leads (34.2%) in the PlasmaBlade group (p < .01) with average percent changes of 6.7% and 4.0% (p < .01), respectively. Lead impedance decreased in 438 leads (52.1%) in the EC group versus 507 leads (61.5%) in the PlasmaBlade group (p < .01) with average percent changes of -5.7% and -7.1% (p < .01), respectively. Lead damage requiring lead revision occurred in five leads (0.6%) or after five procedures (1.2%) in the EC group compared to threeleads (0.4%, p = .50) or after three procedures (0.7%, p = .48) in the PlasmaBlade group. There were no significant differences in the procedural-related complications between the EC group (nine patients, 2.2%) and the PlasmaBlade group (five patients, 1.2%, p = .28). Conventional electrocautery can potentially damage lead insulations. However, this study shows that when used carefully electrocautery is as safe as the PEAK PlasmaBlade™.

Evaluation of tonsillectomy in otolaryngology department, Children’s hospital 1

Objective: Evaluate the result of tonsillectomy in Otolaryngology Department, Children’s Hospital 1. Method: This prospective study was carried out on 312 children that underwent tonsillectomy from April to July, 2019 in Otolaryngology Department, Children’s Hospital 1. Results: For the cautery method: the average surgical time was 8.67 minutes; the average amount of blood loss was 10.32ml; post-operative bleeding rate was 5.04%; average pain score on the 21st day was 2.17; the rate of complete healing on the 7th day was 0%, the 14th day was 58.22% and the 21st day was 96.2%. For Coblator method: average surgery time was 7.92 minutes; average amount of blood loss was 5.27ml; the rate of bleeding after surgery was 1.53%; The mean pain score on 21st day was 1.98; the rate of complete healing was 18.55% on the 7th day, 98.45% on the 14th day and 100% on the 21st day. For plasma method: average surgery time was 9.83 minutes; Average blood loss was 7.15ml; bleeding rate after surgery was 2.56%; the mean pain score on the 21st day was 1.82; The rate of complete healing is 16.21% on the 7th day, 97.44% on the 14th day and 100% on the 21st day. Conclusion: There was no statiscally significant difference in the mean operation time and perioperative blood loss between three surgery techniques (cautery, cobalor, and peak plasma blade). However, there was significant difference in daily pain score and the percentage of post operative hemorrage complication, and the healing in three surgical methods. Decision of operation technique denpended on surgeon’s experience and patient’s financial status. Physician should consider about the secondary hemorrage time to advice on following and caring for patients post surgery appropriately. Key words: Cautery tonsillectomy, Coblator, Peak Plasma , Children’s Hospital 1.

A Retrospective Study of Coronary Artery Bypass Grafting with Low-Thermal Plasma Dissection Device Compared to Conventional Monopolar Electrosurgery.

Introduction:The objective of this study is to compare the effects of conventional monopolar electrosurgery (CMES) and low-thermal plasma kinetic cautery (PKC) on complications such as bleeding, abnormal wound healing, pain, and drainage in patients who underwent on-pump coronary artery bypass grafting (CABG).Methods:This retrospective clinical study included 258 patients undergoing CABG; the patients were randomized to PKC (PEAK PlasmaBlade, n=153) and CMES (n=105) groups. The patients’ clinical data were examined retrospectively for biochemical variables, postoperative drainage, post-surgery erythrocyte suspension transfusion count, surgical site pain examined with visual analogue scale (VAS), and wound healing. Two-sided P-value > 0.05 was considered as statistically significant.Results:The median post-surgery erythrocyte suspension transfusion number was significantly lower with PKC compared to CMES (0 [0-1] vs. 1 [1-4], respectively, P<0.001). Mean postoperative drain output and time until removal of drain tubes were significantly lower with PKC compared to CMES (300±113 vs. 547±192 and 1.95±1.5 vs. 2.44±1.8; P<0.001 and P=0.025, respectively). Mean VAS score for spontaneous and cough-induced pain were significantly lower with PKC compared to CMES (1.98±1.51 vs. 3.94± 2.09 and 3.76±1.46 vs. 5.6±1.92; P<0.001 for both comparisons). Reoperation due to bleeding was significantly higher with CMES compared to PKC (0 vs. 11 [7.2%], P=0.001).Conclusion:Use of PKC during CABG considerably reduces postoperative drainage, need for blood transfusion, reoperation due to bleeding, and postoperative pain. PCK appears to be a good alternative to CMES for CABG.

Plasma Technology Reduces Blood Loss in Adolescent Idiopathic Scoliosis Surgery: A Prospective Randomized Clinical Trial.

Study Design:Prospective randomized clinical trial.Objectives:To assess the effectiveness of PEAK Plasmablade (PPB), compared with bipolar sealer and standard electrocautery, in the posterior spinal instrumentation and fusion (PSF) surgery performed for adolescent idiopathic scoliosis (AIS).Methods:Ninety-three patients undergoing PSF surgery for AIS were randomized in 2 groups: group-A patients (n = 45) underwent PSF surgery using PPB; group-B patients (n = 48) were treated with bipolar sealer and standard electrocautery. Demographic and surgical data was recorded. All the patients underwent serial blood tests on the day before surgery (T0) and at 24 (T1), 48 (T2), 72 (T3), and 96 (T4) hours postoperatively. Visual analogue scale for pain (VAS) score, the percentage of paracetamol assumption, and the blood transfusion rate were recorded in the time-lapse T1 to T4. Intergroup variability was assessed. Pearson correlation test was performed. A P value <.05 was considered significant.Results:In group A, a significantly shorter total operative time (P = .0087), a significantly lower total intraoperative blood loss (TBL) (P = .001), and a higher postoperative hemoglobin (Hb) (P = .01) were recorded. A significant higher mean Hb concentration and mean albumin value was recorded in group A at 24 and 48 hours postoperatively. A significant correlation between TBL and hospital stay was recorded in both groups (group A, P = .00 001; group B, P = .00 006); moreover, in both groups, a significant correlation was observed between TBL and mean VAS at 72 hours postoperatively (group A, P = .0009; group B, P = .0001) and at 96 hours postoperatively (group A, P = .000 044; group B, P = .00 001).Conclusions:PPB reduces the intraoperative blood loss in PSF performed for AIS, thus allowing a patient’s faster recovery.

Effect of low-thermal dissection device versus conventional electrocautery in mastectomy for female-to-male transgender patients.

Subcutaneous mastectomy, the first step in sexual reassignment surgery of female-to-male transsexuals, is associated with high rates of complication and revision surgery. Also, conventional electrosurgery and the associated thermal tissue damage may compromise outcome. This retrospective randomised clinical study evaluated the effect of low-thermal plasma dissection device (PEAK PlasmaBlade, Medtronic, Minneapolis, Minnesota) in comparison with conventional electrosurgery. A total of 17 female-to-male transsexuals undergoing mastectomy were randomised to PEAK PlasmaBlade on one breast side and to monopolar electrosurgery on the other side of the same patient. Wounds of 17 patients were examined histologically for acute thermal injury. Significantly less total volume of drain output (58.8 ± 37.4 mL vs 98.5 ± 76.4 mL; P = .012) was found on the PEAK PlasmaBlade side compared with the electrosurgery side. Duration of drain was significantly shorter on the PEAK PlasmaBlade side (2.5 ± 0.7 days vs 3.2 ± 0.6 days; P = .010). Furthermore, the PEAK PlasmaBlade side showed fewer thermal damages (41.2% vs 82.4%; P = .039) and thermal injury depth from PEAK PlasmaBlade side was less (3170 vs 4060 μm). PEAK PlasmaBlade appears to be superior to monopolar electrosurgery for mastectomy in female-to-male transsexuals, because it demonstrated less thermal tissue damage, less total volume of drain output, and shorter duration of drain, resulting in faster wound healing.

PEAK PlasmaBlade versus monopolar electrocautery tonsillectomy in adults: A prospective double-blinded randomized controlled trial.

To evaluate the efficacy and compare postoperative pain and recovery following PEAK PlasmaBlade and monopolar electrocautery tonsillectomy in adults. Prospective double-blinded randomized controlled trial. Fifty-eight patients were recruited and randomized into 2 groups: PEAK PlasmaBlade (n = 29) or monopolar electrocautery (n = 29) tonsillectomy. Postoperative pain, complications, patient satisfaction, number of tablets of analgesia taken and days taken to return to soft diet, normal diet, normal activities and achieve pain-free swallowing were compared and analysed, with the aid of a pain diary given to patients. Statistical analysis was performed with SPSS 13.0 with statistical significance set at P < 0.05. Patients in the PEAK PlasmaBlade group were able to achieve pain-free swallowing in a shorter time compared to the electrocautery group (13.28 versus 15.76 days, P = 0.035). Patients were also more satisfied with PEAK PlasmaBlade tonsillectomy (P = 0.046). No significant differences in the incidence of postoperative haemorrhage, daily visual analog score for pain, number of tablets of analgesia taken and time taken to return to soft diet, normal diet and activities were seen for both groups. This study showed that PEAK PlasmaBlade tonsillectomy has a faster recovery period in terms of time taken to achieve pain-free swallowing and may offer advantages when compared to monopolar electrocautery tonsillectomy. 1b.

Preventive Effect on Seroma of Use of PEAK PlasmaBlade after Latissimus Dorsi Breast Reconstruction.

Summary:Postoperative seroma is still the main complication after a latissimus dorsi (LD) flap procedure. The etiology of seroma is currently thought to comprise tissue fluids resulting from inflammatory reactions in affected tissue caused by the use of monopolar electrocautery (EC). It is possible that seroma formation can be reduced by using alternative devices such as the PEAK PlasmaBlade (PPB), which provides atraumatic scalpel-like cutting precision while the blade temperature remains close to body temperature. The subjects were 44 patients who underwent breast reconstruction with LD flaps from August 2015 to April 2017. They were retrospectively split into groups treated with a PPB (n = 21) and with conventional EC (n = 23). Outcomes such as rate of seroma formation, total drain discharge volume, indwelling period of drainage at the donor site, length of hospital stay, and operation time were compared between the 2 groups. The incidence of seroma was significantly lower in the PPB group (19.0%) than in the EC group (47.8%). The total drain discharge volume was significantly lower and the indwelling period of drainage and length of hospital stay were significantly shorter in the PPB group. In summary, use of PPB in an LD flap procedure can reduce seroma formation and the lengths of the drainage period and the hospital stay.

Skeletonized internal thoracic artery harvesting: a low thermal damage electrosurgical device provides improved endothelial layer and tendency to better integrity of the vessel wall compared to conventional electrosurgery

BackgroundElectrosurgery is fundamental to the precise, fast and bloodless preparation of internal thoracic artery grafts in cardiac surgery. The PEAK PlasmaBlade is a monopolar electrosurgical device that uses pulsed radiofrequency energy to generate a plasma-mediated discharge along an insulated electrode, creating a cutting edge while the blade stays near body temperature. The aim of this study is to compare the histological samples, cardiac computed-tomography of graft patency, and clinical outcomes of patients after off-pump coronary artery bypass grafting with preparation of the internal thoracic arteries by a conventional electrosurgical device and the PlasmaBlade.MethodsIn twenty subjects one internal thoracic artery was prepared with PlasmaBlade and the other artery with a conventional electrosurgical device. Histological samples were evaluated for three factors for potential graft failure: endothelial damage, integrity of the vessel wall and adventitial hemorrhage. Five samples per artery were evaluated by a novel scoring method based on the exposed circumference of the histological sample (“0”: 0%, “1”: 1–25%, “2”: 26–50%, “3”: 51–75%, “4”: ≥76% of the circumference). The Wilcoxon signed ranks test for mean scores within subjects was performed. Six-month-follow up by cardiac computed tomography for evaluation of graft patency was completed in 16 patients.ResultsHistological results demonstrated significantly less endothelial damage after PlasmaBlade (83% vs 60%, absolute: 75/90 vs. 53/89 samples with score “0–1”, p = 0.04). PlasmaBlade samples demonstrated a tendency to better wall integrity (72% vs. 54%, absolute: 64/89 vs. 47/87 samples with score “0–1”, p = 0.32). There were no differences in endothelial bleeding (PlasmaBlade 46% vs. electrosurgery 53%, absolute: 41/88 vs. 48/90 samples with score “0–1”, p = 0.63). Computed tomography confirmed non-inferiority of the PlasmaBlade to conventional electrosurgery with a patency rate of 94%.ConclusionHistologically, internal thoracic arteries harvested with PlasmaBlade demonstrate a more intact endothelial layer and a tendency to better wall integrity. Computed tomography of graft patency speaks for non-inferiority to conventional electrosurgery. PlasmaBlade may be preferable to conventional electrosurgery, if further follow-up confirms patency of internal thoracic arteries.Trial registrationNCT03510026, registered 4th April 2018 (retrospectively registered).

Novel Application of Pulsed Radiofrequency Energy Device (PEAK Plasmablade) in Neurosurgical Reconstructive Surgery

Novel Application of Pulsed Radiofrequency Energy Device (PEAK Plasmablade) in Neurosurgical Reconstructive Surgery

Use of Pulsed Radiofrequency Energy Device (PEAK Plasmablade) in Neuromodulation Implant Revisions.

Battery replacement or revision surgery for neuromodulation implants is conventionally performed using sharp dissection. Meticulous dissection within thick scar tissue is vital to avoid damage to surrounding lead(s), which could result in more extensive revision surgery. Traditional electrosurgery devices are contraindicated as the emitted energy can be transferred to the hardware, resulting in implant or tissue damage with severe consequent complications. We report our experience and potential applications of a novel, pulsed monopolar radiofrequency energy device (PEAK PlasmaBlade, Medtronic PLC, Minneapolis, Minnesota, USA), which facilitates dissection around implants without the risk of damaging or transmitting energy through the system. We conducted a 2-center retrospective study to review the indications, safety, and efficacy of the PlasmaBlade in 57 cases requiring either neuromodulation system replacement or revision. Deep brain stimulator (DBS) battery replacements were undertaken in 45 cases, 8 vagal nerve stimulator battery revisions, 2 intrathecal baclofen system revision, 1 DBS extension revision, and 1 DBS scar revision around the cranial portion of the lead. All cases proceeded without adverse event or damage to lead/generator and with a subjective and objective impression of significant time savings. Average operating times for battery replacements were reduced from 37 to 26 minutes (P= 0.015). In our experience, the PlasmaBlade is safe to use in revising/replacing neuromodulation implants. We observed no damage or transmission of energy to the implants or leads; additional advantages of the system include reduced operating times, less damage to surrounding tissue, and the potential to facilitate revision procedures in awake patients under local anesthesia.

Wound healing and postsurgical complications in breast cancer surgery: a comparison between PEAK PlasmaBlade and conventional electrosurgery - a preliminary report of a case series.

PurposePEAK PlasmaBlade is a recent and distinctive type of electrosurgical device. Previous studies have already documented some meaningful advantages of this device over conventional electrosurgery. This study compared the use of PEAK PlasmaBlade to standard electrosurgery in mastectomy and breast conservative surgery. The purpose was to test the impact of PEAK PlasmaBlade on the wound-healing process and on postsurgical complications in breast cancer surgery.MethodsSixty patients undergoing breast cancer surgery were enrolled. The PEAK PlasmaBlade was used for 20 of those. A standard electrosurgical device was used for the other 40 patients. The 2 groups were homogenous in age, body mass index, comorbidities and type of surgery. We recorded wound complications, serum drainage amount and duration of stay, blood loss, time of surgery, length of hospital stay, and total number of medications required.ResultsThe 2 groups were not significantly different in terms of patient characteristics. A statistically significant reduction in incidence of seroma was observed in the PEAK group: only 10% versus 37.5% of the patients in the conventional electrosurgery group developed this complication (Fisher exact test, P = 0.034).ConclusionSeroma is the most important wound complication in breast surgery. The research of new instruments that might reduce its incidence is desirable. In order to validate or deny the results of this study, it is necessary to enroll more subjects and to consider the impact of this device on axillary lymph node dissection.

Postoperative tonsillectomy bleeding complications in children: A comparison of three surgical techniques

Objective & hypothesisStated in the Null form: There will be no difference in primary or secondary hemorrhage rate in children undergoing tonsillectomy or adenotonsillectomy across three surgical techniques: PEAK Plasmablade, electric monopolar cautery, coblation. Study designRetrospective chart analysis. SettingAcademic Medical Center: Children's Hospital. Subjects & methodsElectronic chart data were collected from patient's age 2–18 years who underwent tonsillectomy, with or without adenoidectomy, at a tertiary pediatric hospital between June 2011 to May 2013 by electric monopolar cautery, coblation, or PEAK PlasmaBlade. Treatment outcomes following each of these surgical approaches, relative to rate of post-operative primary and secondary bleeding, hospital admission, and emergency department visits were compared. ResultsA total of 1780 patients that had tonsillectomy or adenotonsillectomy were evaluated. There was a significant difference in bleed rate by age with older patients having more bleeding post-procedure than their younger counterparts. There was also a difference in bleeding frequency by diagnosis. Patients with a diagnosis of OSA were less likely to experience a postoperative bleed than children with either recurrent tonsillitis or both. Significance was evident between post-op hemorrhage rate and instrumentation (χ2 = 11.17, df = 2, p = 0.004). The majority of bleeds occurred with coblation (58.9%), while PEAK had only 17.8% and cautery 23%. ConclusionThe null hypothesis was rejected. That is, PEAK PlasmaBlade was safe and effective, with statistically less postoperative bleeding and ED visits, especially when compared to coblation techniques. Coblation patients had the highest rates of postoperative bleeding.

Is capsulectomy a feasible and useful measure in internal pulse generator replacement procedures? A technical note on the use of the PEAK PlasmaBlade(TM).

Implantable pulse generator (IPG) replacement is considered a simple procedure, but in case of extension cable damage or IPG pocket infection, it can dramatically affect a patient's quality of life. Higher risk of infection has been reported after IPG replacement procedures rather than after primary deep brain stimulation lead implantation, and some authors suggested that the IPG pocket capsule could play a pivotal role in causing it. In this technical note we present a capsulectomy technique adopted in IPG replacement procedures. Between July and October 2015, we carried out ten outpatient IPG replacement procedures at the chest and abdomen under local anesthesia for battery depletion using the PEAK PlasmaBlade(TM). All patients were followed for at least 2months to rule out any hardware malfunction and infection. All ten procedures were uneventful. No extension cable damage occurred. No IPG pocket infection occurred, also not in the follow-up. Mean surgical time was 30min. Complete capsulectomy is not feasible with basic surgical instruments, and the PEAK PlasmaBlade(TM) pencil appears to be a helpful tool in carrying out the procedure.

A Study of the PEAK PlasmaBlade TnA in Adult Tonsillectomy Compared to Traditional Electrosurgery

Objective: Recently, the use of low temperature pulsed radiofrequency (RF) energy has emerged as a method for efficient tissue dissection with minimal thermal damage. When used for tonsillectomy, anecdotal reports have cited improved recovery compared with traditional electrosurgery (ie, Bovie). We evaluated this technology in adults undergoing subcapsular tonsillectomy. Method: Twenty adults were prospectively enrolled in this pilot study. Subjects were randomized to tonsillectomy with the PlasmaBlade (PB) or traditional electrosurgery (ES). Intra-operative time and blood loss were recorded; postoperatively, subjects blindly reported visual analog scale painscores, narcotic consumption, diet volume, and activity level using a validated form. Results: The population age (34.7 ± 18.7 years, P = .75) and BMI (24.7 ± 3.9 kg/m2, P = .44) were equivalent. Operative time was also equivalent for both technologies (7:36 ± 1:58 min, P = .99) with PB subjects demonstrating a 69% reduction in IBL (1.6 ± 1.8 vs 5.3 ± 7.9mL, P = .02) compared with ES. Postoperatively, PB subjects demonstrated a 40% (2.5 ± 1.2 vs 4.1 ± 0.7 Tylenol-Codeine/d, P = .002) reduction in narcotic consumption over the 10-day monitoring period. Modest improvements in activity level (6%; P = .83), diet volume (20%, P = .32), and VAS pain score (12%, P = .41) were also reported. However, these were not statistically significant. Conclusion: The use of this new low-thermal damage electrosurgical technology for adult tonsillectomy appears to offer several advantages over traditional electrosurgery, notably in reducing narcotic consumption in the postoperative period. Larger population-based studies should be conducted to further examine these endpoints.

Comparative Healing of Human Cutaneous Surgical Incisions Created by the PEAK PlasmaBlade, Conventional Electrosurgery, and a Standard Scalpel

The authors investigated thermal injury depth, inflammation, and scarring in human abdominal skin by comparing the histology of incisions made with a standard "cold" scalpel blade, conventional electrosurgery, and the PEAK PlasmaBlade, a novel, low-thermal-injury electrosurgical instrument. Approximately 6 and 3 weeks before abdominoplasty, full-thickness incisions were created in the abdominal pannus skin of 20 women, using a scalpel (scalpel), the PlasmaBlade, and a conventional electrosurgical instrument. Fresh (0-week) incisions were made immediately before surgery. After abdominoplasty, harvested incisions were analyzed for scar width, thermal injury depth, burst strength, and inflammatory response. Acute thermal injury depth was reduced 74 percent in PlasmaBlade incisions compared with conventional electrosurgical instrument (p < 0.001). Significant differences in inflammatory response were observed at 3 weeks, with mean CD3 response (T-lymphocytes) 40 percent (p = 0.01) and 21 percent (p ≈ 0.12) higher for the conventional electrosurgical instrument and PlasmaBlade, respectively, compared with the scalpel. CD68 response (monocytes/macrophages) was 52 percent (p = 0.05) and 16 percent (p ≈ 0.35) greater for a conventional electrosurgical instrument and the PlasmaBlade, respectively. PlasmaBlade incisions demonstrated 65 percent (p < 0.001) and 42 percent (p < 0.001) stronger burst strength than a conventional electrosurgical instrument, with equivalence to the scalpel at the 3- and 6-week time points, respectively. Scar width was equivalent for the PlasmaBlade and the scalpel at both time points, and 25 percent (p = 0.01) and 12 percent (p = 0.15) less than for electrosurgery, respectively. PlasmaBlade incisions demonstrated reduced thermal injury depth, inflammatory response, and scar width in healing skin compared with electrosurgery. These results suggest that the PlasmaBlade may provide clinically meaningful advantages over conventional electrosurgery during human cutaneous wound healing. Therapeutic, II.(Figure is included in full-text article.).

Discussion: Comparative Healing of Human Cutaneous Surgical Incisions Created by the PEAK PlasmaBlade, Conventional Electrosurgery, and a Standard Scalpel

Discussion: Comparative Healing of Human Cutaneous Surgical Incisions Created by the PEAK PlasmaBlade, Conventional Electrosurgery, and a Standard Scalpel

Comparative Healing of Surgical Incisions Created by the PEAK PlasmaBlade, Conventional Electrosurgery, and a Scalpel

The PEAK PlasmaBlade is a new electrosurgical device that uses pulsed radiofrequency to generate a plasma-mediated discharge along the exposed rim of an insulated blade, creating an effective cutting edge while the blade stays near body temperature. Full-thickness incisions were made on the dorsums of pigs with the PlasmaBlade, a conventional electrosurgical device, and a scalpel, and blood loss was quantified. Wounds were harvested at designated time points, tested for wound tensile strength, and examined histologically for scar formation and tissue damage. Bleeding was reduced significantly (59 percent) in PlasmaBlade incisions compared with scalpel incisions, and acute thermal damage from the PlasmaBlade (66 +/- 5 microm) was significantly less than both cut and coagulation mode electrosurgical incisions (456 +/- 35 microm and 615 +/- 22 microm, respectively). Histologic scoring for injury and wound strength was equivalent between the PlasmaBlade and scalpel incisions. By 6 weeks, the healed PlasmaBlade and scalpel incisions were approximately three times stronger, and scar cosmetic appearance was significantly better compared with electrosurgical incisions. The PlasmaBlade is a promising new surgical instrument that provides atraumatic, scalpel-like cutting precision and electrosurgical-like hemostasis, resulting in minimal bleeding, tissue injury, and scar formation.

Evaluation of the PEAK PlasmaBlade for ENT Surgery

Problem Traditional electrosurgical instruments are known to have an associated zone of thermal injury to the residual tissue. The compromised tissue left behind in the body may compromise wound healing and also may cause post operative pain. The PEAK PlasmaBlade is a new tissue dissection tool that uses pulsed radiofrequency energy to generate a highly focused plasma field at the tip of the device. This creates an effective cutting edge with simultaneous hemostasis while the blade remains near body temperature. A comparative study of tissue cutting and hemostasis was conducted to evaluate the characteristics of this technology. Methods Porcine mucosal and lymphoid tissue was subjected to a series of surgical incisions using the PlasmaBlade, a scalpel, a traditional electrosurgery (bovie) blade style tip, and a Coblation EVac 70 wand. Both low and high settings were evaluated for PlasmaBlade, bovie, and Coblation. Blood loss following the cut was evaluated. Histology samples were harvested immediately after and evaluated for collateral tissue damage at the incision site. Thermal imaging of all the devices in an active cutting mode was also conducted. Results Histological evaluation of the tissue samples showed that the PlasmaBlade cuts produced minimal collateral damage compared to cuts made with the other electrosurgical instruments, which demonstrated greater thermal damage. Bleeding control (hemostasis) was equivalent for the Plasma-Blade versus bovie and Coblation. Thermal imaging showed the PlasmaBlade operating in a range of 40 to 100 C which was similar to the Coblation operating temperatures. Traditional electrosurgery produced temperatures well in excess of 200 C. Conclusion The PEAK PlasmaBlade is a promising new instrument which provides atraumatic, scalpel–like, cutting and bovie-like hemostasis, resulting in minimal bleeding and tissue injury. Significance There is great potential for this becoming an important tool for common ENT procedures such as tonsillectomy and adenoidectomy, specifically in reducing the pain and morbidity of recovery.