Comparative healing of surgical incisions created by the PEAK PlasmaBlade, conventional electrosurgery, and a scalpel.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Loh
Shang A
SA
Stanford, Palo Alto, and San Francisco, Calif. From the Department of Surgery, Division of Plastic Surgery, and the Department of Ophthalmology and Hansen Experimental Physics Laboratory, Stanford University, PEAK Surgical, Inc., and the Department of Pathology and Laboratory Medicine, University of California, San Francisco.
Carlson
Grace A
GA
Chang
Edward I
EI
Huang
Eric
E
Palanker
Daniel
D
Gurtner
Geoffrey C
GC
D000818:Animals; D016063:Blood Loss, Surgical; D002921:Cicatrix / Q000473:pathology* / Q000517:prevention & control; D062109:Dermatologic Surgical Procedures; D004195:Disease Models, Animal; D004598:Electrosurgery / Q000295:instrumentation* / Q000379:methods; D007150:Immunohistochemistry; D018836:Inflammation Mediators / Q000032:analysis; D011336:Probability; D011897:Random Allocation; D012867:Skin / Q000473:pathology; D013525:Surgical Instruments; D013552:Swine; D013718:Tensile Strength; D014945:Wound Healing / Q000502:physiology*
D018836:Inflammation Mediators