title: Comparative healing of rat fascia following incision with three surgical instruments.
abstract: BACKGROUND
  Incisional hernia and fascial dehiscence are associated with significant postoperative morbidity. Electrosurgical devices using pulsed radiofrequency energy and a novel electrode design markedly reduce thermal injury during cutting and coagulation while maintaining equal surgical performance. In this study, we examine fascial healing dynamics in a rat model following incision with a pulsed radiofrequency energy device (PRE), a conventional electrosurgical device, and a standard "cold" scalpel. We hypothesize that incisions made with the pulsed radiofrequency energy device will result in a superior fascial healing profile compared with conventional electrosurgery.
  
  
  METHODS
  Full thickness surgical incisions were created in rat fascia using a commercially available PRE device, conventional electrosurgery, and a scalpel. Harvested fascial specimens were analyzed for burst strength testing and healing-associated histologic characteristics at d 7, 14, 21, and 42.
  
  
  RESULTS
  PRE incisions were fully healed by 6 wk with normal tissue architecture. By all measures, wounds created by the PRE device were comparable to those made with the standard scalpel. Compared with PRE, conventional electrosurgery incisions exhibited a larger zone of tissue injury (68% greater in Coag mode, P < 0.0001; 46% greater in Cut mode, P < 0.001), an increased inflammatory response and a less favorable wound architecture. In the immediate postoperative period (1 wk), burst strength testing demonstrated that PRE fascial wounds were significantly stronger than those made by electrosurgery in Coag mode (318%, P = 0.001).
  
  
  CONCLUSIONS
  The favorable fascial healing profile of the PRE device suggests that it is a promising new surgical technology. The early improved strength of wounds made with this device is of particular interest, as wound dehiscence is of greatest concern early in the healing process.
authors.affiliation: Department of Surgery, Division of Plastic Surgery, Stanford University School of Medicine, Stanford, California 94305, USA.
authors.forename: Edward I
authors.initials: EI
authors.lastname: Chang
authors.forename: Grace A
authors.initials: GA
authors.lastname: Carlson
authors.forename: Joshua G
authors.initials: JG
authors.lastname: Vose
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Huang
authors.forename: George P
authors.initials: GP
authors.lastname: Yang
mesh_terms: D000818:Animals; D017115:Catheter Ablation / Q000295:instrumentation*; D003094:Collagen / Q000378:metabolism; D004598:Electrosurgery / Q000295:instrumentation*; D000071938:Fasciotomy; D007249:Inflammation / Q000473:pathology; D008297:Male; D023421:Models, Animal; D051381:Rats; D017207:Rats, Sprague-Dawley; D013525:Surgical Instruments; D013529:Surgical Wound Dehiscence / Q000473:pathology; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology*
chemical_list: D003094:Collagen