title: Healing of iatrogenic skeletal muscle wounds is affected by incision device.
abstract: Orthopedic joint procedures frequently require extensive dissection of skeletal muscles resulting in tissue injury, formation of scar tissue, pain, and potentially, functional impairment. The authors hypothesized that using a low-temperature ultrasonic cutting and coagulating device (Harmonic Blade, Ethicon Endo-Surgery, Cincinnati, OH) would result in reduction in tissue trauma in terms of reducing acute and chronic inflammation during healing. Bilateral longitudinal incisions were made into the tibialis cranialis muscles of rabbits with either a Harmonic Blade or a standard monopolar electrosurgical scalpel. At 3, 7, and 21 days postoperatively, necropsy and histological evaluations indicated a significant attenuation of acute inflammation (P = .011) for the Harmonic incisions compared with electrosurgery. No significant differences were observed for chronic inflammation, necrosis, or fibrosis. Use of a Harmonic scalpel during dissection of skeletal muscle in orthopedic surgery may result in reduced influx of neutrophils, reducing acute inflammation, and potentially aid in reducing postoperative pain and functional impairment.
authors.affiliation: Wright State University, Dayton, OH, USA.
authors.forename: L Joseph
authors.initials: LJ
authors.lastname: Rubino
authors.forename: Emmanuel K
authors.initials: EK
authors.lastname: Konstantakos
authors.forename: Harold F
authors.initials: HF
authors.lastname: Stills
authors.forename: Emily S
authors.initials: ES
authors.lastname: Dudley
authors.forename: Beverly K
authors.initials: BK
authors.lastname: Grunden
authors.forename: Prasanna
authors.initials: P
authors.lastname: Malaviya
mesh_terms: D000818:Animals; D004210:Dissection / Q000295:instrumentation; D005260:Female; D023421:Models, Animal; D018482:Muscle, Skeletal / Q000473:pathology* / Q000502:physiology*; D019637:Orthopedic Procedures / Q000295:instrumentation*; D011817:Rabbits; D014464:Ultrasonic Therapy / Q000295:instrumentation*; D014945:Wound Healing