Effective bone hemostasis and healing using radiofrequency and conductive fluid.
Hemostasis in bone is difficult to achieve because of the mineral content. Current techniques often are ineffective, can have systemic effects, or leave residual material in the wound. Our hypotheses were that a wand device coupling radiofrequency energy with a cooling conductive saline solution, applied topically to bone, could produce superior hemostasis compared with conventional electrocautery or no treatment, and not impede bone healing. Immediate hemostasis and subsequent bone healing for 6 and 12 weeks were evaluated in an iliac crest ostectomy (cancellous bone) and a drilled tibia defect (cortical bone) sheep model. Outcome variables were amount and intensity of bleeding, serial radiography, quantitative computed tomography, histology and mechanical testing. Control of bleeding was nearly complete (93%) and greater with the radiofrequency/saline treatment compared with electrocautery (56%) or no treatment (0%) in cancellous bone and cortical bone. Electrocautery induced surface char (black carbon debris) that could be seen at 6 and 12 weeks. There were no differences in bone healing between the radiofrequency and electrocautery device applications or untreated bone. At 12 weeks, all healing tibiae defects were as strong as undrilled tibiae. This may be an effective method to produce rapid hemostasis in bone without char or healing complications.
Comparative Orthopedic Research Laboratories, Department of Veterinary Clinical Sciences, College of Veterinary Medicine, the Ohio State University, Columbus, OH, USA. bertone.1@osu.edu
Alicia
A
Bertone
David
D
Lipson
Janet
J
Kamei
Alan
A
Litsky
Stephen
S
Weisbrode
D000818:Animals; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001861:Bone Regeneration / Q000502:physiology*; D017115:Catheter Ablation; D004195:Disease Models, Animal; D004564:Electrocoagulation; D006488:Hemostasis, Surgical / Q000379:methods*; D007085:Ilium / Q000601:surgery; D010027:Osteotomy; D012756:Sheep; D013977:Tibia / Q000601:surgery; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*