Comparison of lateral thermal injury and healing of porcine skin incisions performed by CO₂‐laser, monopolar electrosurgery and radiosurgery: a preliminary study based on histological and immunohistochemical results

Abstract

CO(2) laser incisions exhibit more extensive LTI, epithelial cell proliferation, and inflammatory response. Confirmation of these findings requires a greater sample.

Healing of canine skin incisions made with monopolar electrosurgery versus scalpel blade

“…Dermal cellular infiltrate reflects the inflammatory response and was more pronounced on histological examination of all electrosurgical incisions. This finding diverges from previous studies reporting similar cellular infiltrate in electrosurgical and scalpel skin incisions . This discrepancy may reflect species differences as these studies were performed on rats and pigs.…”

“…Edema, or fluid accumulation within the interstitial space, is an indicator of acute inflammatory response and did not differ between groups . This finding confirms previous reports documenting similar cellular progression of inflammation between groups . Dermal cellular infiltrate reflects the inflammatory response and was more pronounced on histological examination of all electrosurgical incisions.…”

“…Thermal necrosis spread into tissues adjacent to the incision in all electrosurgical wounds, in pattern similar to burns. While lateral thermal spread has been associated with delayed healing, 6,9,16,20,[23][24][25][26][27] the authors are not aware of studies comparing the healing of electrosurgical incisions to that of burns. Thermal necrosis was absent in surgical incisions created with a scalpel blade.…”

“…The of use electrosurgery was consequently discouraged for cutaneous incision. More recent human clinical trials have challenged this recommendation as judicious use of monopolar electrosurgery reduced blood loss and surgical time, without influencing inflammation or complications associated with skin incisions . This discrepancy may be explained by the use of coagulation or blended waveforms with higher power settings, leading to excessive collateral tissue damage in older research …”

“…More recent human clinical trials have challenged this recommendation as judicious use of monopolar electrosurgery reduced blood loss and surgical time, without influencing inflammation or complications associated with skin incisions. [10][11][12][13][14][15][16] This discrepancy may be explained by the use of coagulation or blended waveforms with higher power settings, leading to excessive collateral tissue damage in older research. 15 No veterinary studies have recently focused on the effects of monopolar electrosurgical incision in a cutting mode and with lower power settings on cutaneous healing.…”